Provider Demographics
NPI:1437496650
Name:LUTHERAN SOCIAL SERVICES OF CENTRAL OHIO CARE,LLC
Entity Type:Organization
Organization Name:LUTHERAN SOCIAL SERVICES OF CENTRAL OHIO CARE,LLC
Other - Org Name:LSS HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:G
Authorized Official - Last Name:STUCKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-281-8711
Mailing Address - Street 1:1665 EXECUTIVE CT APT 111
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907-2674
Mailing Address - Country:US
Mailing Address - Phone:419-281-8711
Mailing Address - Fax:614-431-0596
Practice Address - Street 1:1665 EXECUTIVE CT APT 111
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-2674
Practice Address - Country:US
Practice Address - Phone:419-281-8711
Practice Address - Fax:614-431-0596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-08
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2301306Medicaid
OH2301306Medicaid