Provider Demographics
NPI:1033773452
Name:OHIO LIVING COMMUNITIES
Entity Type:Organization
Organization Name:OHIO LIVING COMMUNITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE MANAGER OF MANAGED CARE
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:PERKINS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:614-888-7800
Mailing Address - Street 1:1001 KINGSMILL PKWY
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-1129
Mailing Address - Country:US
Mailing Address - Phone:614-888-7800
Mailing Address - Fax:614-888-6864
Practice Address - Street 1:1150 W MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-7129
Practice Address - Country:US
Practice Address - Phone:330-867-2150
Practice Address - Fax:330-867-1642
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OHIO LIVING COMMUNITIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-01
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0200400Medicaid