Provider Demographics
NPI:1629532015
Name:MERIT HOUSE LLC.
Entity Type:Organization
Organization Name:MERIT HOUSE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-478-5131
Mailing Address - Street 1:4645 LEWIS AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43612-2336
Mailing Address - Country:US
Mailing Address - Phone:419-478-5131
Mailing Address - Fax:419-470-0043
Practice Address - Street 1:4645 LEWIS AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43612-2336
Practice Address - Country:US
Practice Address - Phone:419-478-5131
Practice Address - Fax:419-470-0043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-30
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0112299Medicaid