Provider Demographics
NPI:1407949241
Name:MEDICAL FACILITIES OF AMERICA LXXV (75) LP
Entity Type:Organization
Organization Name:MEDICAL FACILITIES OF AMERICA LXXV (75) LP
Other - Org Name:LEXINGTON HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO, MFA INC. GENERAL PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CLAUDE
Authorized Official - Middle Name:NOVEL
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:504-776-7526
Mailing Address - Street 1:2917 PENN FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-4374
Mailing Address - Country:US
Mailing Address - Phone:540-989-3618
Mailing Address - Fax:540-774-9443
Practice Address - Street 1:17 CORNELIA ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-4140
Practice Address - Country:US
Practice Address - Phone:336-242-1349
Practice Address - Fax:336-242-1380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0527310400000X, 313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC340601PMedicaid
NC7801685OtherREST HOME PROVIDER NUMBER
NC3405419Medicaid
345419Medicare Oscar/Certification