Provider Demographics
NPI:1407271299
Name:LAKERIDGE ACRES NURSING & REHABILITATION CENTER LLC
Entity Type:Organization
Organization Name:LAKERIDGE ACRES NURSING & REHABILITATION CENTER LLC
Other - Org Name:LAKERIDGE VILLA HEALTHCARE & REHAB CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HELENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-729-2300
Mailing Address - Street 1:7220 PIPPIN RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-4607
Mailing Address - Country:US
Mailing Address - Phone:513-729-2300
Mailing Address - Fax:513-728-7354
Practice Address - Street 1:7220 PIPPIN RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-4607
Practice Address - Country:US
Practice Address - Phone:513-729-2300
Practice Address - Fax:513-728-7354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-03
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5298314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility