Provider Demographics
NPI:1083423396
Name:LINCOLN RESIDENCES
Entity type:Organization
Organization Name:LINCOLN RESIDENCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:ORDONA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:916-408-7199
Mailing Address - Street 1:4970 WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95841-3707
Mailing Address - Country:US
Mailing Address - Phone:916-408-7199
Mailing Address - Fax:877-466-7829
Practice Address - Street 1:1408 ALDER CREEK CT
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:CA
Practice Address - Zip Code:95648-8248
Practice Address - Country:US
Practice Address - Phone:916-408-7199
Practice Address - Fax:877-166-7829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-01
Last Update Date:2025-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility