Provider Demographics
NPI:1144787573
Name:OHIO LIVING COMMUNITIES
Entity Type:Organization
Organization Name:OHIO LIVING COMMUNITIES
Other - Org Name:OHIO LIVING SWAN CREEK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:STILLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-888-7800
Mailing Address - Street 1:9200 WORTHINGTON RD STE 300
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-7240
Mailing Address - Country:US
Mailing Address - Phone:614-888-7800
Mailing Address - Fax:614-888-6864
Practice Address - Street 1:1650 SWAN CREEK LN
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-1286
Practice Address - Country:US
Practice Address - Phone:419-865-4445
Practice Address - Fax:419-865-1194
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OHIO LIVING COMMUNITIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-21
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2296411Medicaid