Provider Demographics
NPI:1053449926
Name:PROJECT LINDEN, INC.
Entity type:Organization
Organization Name:PROJECT LINDEN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-221-7790
Mailing Address - Street 1:1410 CLEVELAND AVE.
Mailing Address - Street 2:SUITE #2
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43211
Mailing Address - Country:US
Mailing Address - Phone:614-221-7790
Mailing Address - Fax:614-221-9164
Practice Address - Street 1:1410 CLEVELAND AVE.
Practice Address - Street 2:SUITE #2
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43211
Practice Address - Country:US
Practice Address - Phone:614-221-7790
Practice Address - Fax:614-221-9164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH25-674-01Medicaid
OH01212OtherUPI NUMBER