Provider Demographics
NPI:1033156914
Name:LUTHERAN ORPHANS AND OLD FOLKS HOME AT NAPOLEON
Entity Type:Organization
Organization Name:LUTHERAN ORPHANS AND OLD FOLKS HOME AT NAPOLEON
Other - Org Name:LUTHERAN NURSING AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHURTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-861-4990
Mailing Address - Street 1:2021 N MCCORD RD
Mailing Address - Street 2:STE B
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-3030
Mailing Address - Country:US
Mailing Address - Phone:419-861-4990
Mailing Address - Fax:419-861-2710
Practice Address - Street 1:1036 S PERRY ST
Practice Address - Street 2:
Practice Address - City:NAPOLEON
Practice Address - State:OH
Practice Address - Zip Code:43545-2159
Practice Address - Country:US
Practice Address - Phone:419-592-1688
Practice Address - Fax:419-599-4791
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LUTHERAN HOMES SOCIETY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-01
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3561314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0581302Medicaid
OH000000296493OtherANTHEM/BCBS
OH0581302Medicaid
OH366162Medicare ID - Type Unspecified