Provider Demographics
NPI:1043209828
Name:HUFFMAN HEALTH CARE, INC.
Entity Type:Organization
Organization Name:HUFFMAN HEALTH CARE, INC.
Other - Org Name:LIVINGSTON CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:TONEY
Authorized Official - Middle Name:
Authorized Official - Last Name:VICARS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-541-4600
Mailing Address - Street 1:20 LIVINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45403-2938
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20 LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45403-2938
Practice Address - Country:US
Practice Address - Phone:937-476-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6235314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2431961Medicaid
OH365651Medicare ID - Type Unspecified