Provider Demographics
NPI:1083929186
Name:HIGHLAND OAKS HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:HIGHLAND OAKS HEALTH CENTER, LLC
Other - Org Name:HIGHLAND OAKS HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:AHRON
Authorized Official - Middle Name:
Authorized Official - Last Name:LIEBERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-206-9059
Mailing Address - Street 1:4114 N STATE ROUTE 376 NW
Mailing Address - Street 2:
Mailing Address - City:MCCONNELSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43756-9145
Mailing Address - Country:US
Mailing Address - Phone:740-962-3761
Mailing Address - Fax:740-962-3001
Practice Address - Street 1:4114 N STATE ROUTE 376 NW
Practice Address - Street 2:
Practice Address - City:MCCONNELSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43756-9145
Practice Address - Country:US
Practice Address - Phone:740-962-3761
Practice Address - Fax:740-962-3001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-12
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3078842Medicaid
OH3078842Medicaid