Provider Demographics
NPI:1467411850
Name:LPN HEALTH CARE FACILITY INC
Entity Type:Organization
Organization Name:LPN HEALTH CARE FACILITY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACI
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:740-366-2321
Mailing Address - Street 1:151 PRICE RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-3317
Mailing Address - Country:US
Mailing Address - Phone:740-366-2321
Mailing Address - Fax:740-366-8623
Practice Address - Street 1:151 PRICE RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-3317
Practice Address - Country:US
Practice Address - Phone:740-366-2321
Practice Address - Fax:740-366-8623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH365481314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0359795Medicaid
OH365481Medicare ID - Type UnspecifiedMEDICARE