Provider Demographics
NPI:1871624650
Name:LINDEN-KILDARE CISD
Entity type:Organization
Organization Name:LINDEN-KILDARE CISD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LARONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-756-5027
Mailing Address - Street 1:205 KILDARE RD
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:TX
Mailing Address - Zip Code:75563-5620
Mailing Address - Country:US
Mailing Address - Phone:903-756-5027
Mailing Address - Fax:903-756-7242
Practice Address - Street 1:205 KILDARE RD
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:TX
Practice Address - Zip Code:75563-5620
Practice Address - Country:US
Practice Address - Phone:903-756-5027
Practice Address - Fax:903-756-7242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX064402302Medicaid