Provider Demographics
NPI:1174824072
Name:LUTHER GROVE TOLEDO
Entity Type:Organization
Organization Name:LUTHER GROVE TOLEDO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRCT. OF HOUSING & COMMU
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:LESTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-724-1525
Mailing Address - Street 1:2411 SEAMAN ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43605-1519
Mailing Address - Country:US
Mailing Address - Phone:419-724-1525
Mailing Address - Fax:
Practice Address - Street 1:2502 SEAMAN ST # 2510
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43605-1500
Practice Address - Country:US
Practice Address - Phone:419-698-1919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management