Provider Demographics
NPI:1275529273
Name:OHIO LIVING COMMUNITIES
Entity Type:Organization
Organization Name:OHIO LIVING COMMUNITIES
Other - Org Name:OHIO LIVING WESTMINSTER THURBER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:C
Authorized Official - Last Name:GUMINA
Authorized Official - Suffix:
Authorized Official - Credentials:
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 1:717 NEIL AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-1609
Practice Address - Country:US
Practice Address - Phone:614-228-8888
Practice Address - Fax:614-228-8898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-25
Last Update Date:2019-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4793314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0034297Medicaid
OH000000216393OtherANTHEM BC/BS
OH000000216393OtherANTHEM BC/BS