Provider Demographics
NPI:1407859481
Name:ANDERSON HEALTHCARE, LTD
Entity Type:Organization
Organization Name:ANDERSON HEALTHCARE, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NHA
Authorized Official - Prefix:
Authorized Official - First Name:AKIVA
Authorized Official - Middle Name:
Authorized Official - Last Name:WAGSCHAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-474-6200
Mailing Address - Street 1:PO BOX 541084
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45254-1084
Mailing Address - Country:US
Mailing Address - Phone:513-474-6200
Mailing Address - Fax:513-388-3000
Practice Address - Street 1:8139 BEECHMONT AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-3152
Practice Address - Country:US
Practice Address - Phone:513-474-6200
Practice Address - Fax:513-388-3000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2168314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2044764Medicaid
OH2044764Medicaid