Organization
LINDA GOODE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA GOODE (OWNER/AFC PROVIDER)
(936) 414-6918
Entity
Organization
Contact information
Practice address
111 PLUM ST, RUSK, TX 75785-2327
(936) 414-6918
Mailing address
111 PLUM ST, RUSK, TX 75785-2327
(936) 414-6918
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
137067
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000950100
—
TX
Enumeration date
09/17/2014
Last updated
09/17/2014
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