Provider Demographics
NPI:1710343801
Name:LUTHERAN HOMES SOCIETY, INC.
Entity Type:Organization
Organization Name:LUTHERAN HOMES SOCIETY, INC.
Other - Org Name:TOLEDO ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VP/CFO
Authorized Official - Prefix:
Authorized Official - First Name:LORINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHALK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-861-4906
Mailing Address - Street 1:2519 SEAMAN ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43605-1509
Mailing Address - Country:US
Mailing Address - Phone:419-724-1414
Mailing Address - Fax:419-693-1026
Practice Address - Street 1:2519 SEAMAN ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43605-1509
Practice Address - Country:US
Practice Address - Phone:419-724-1414
Practice Address - Fax:419-693-1026
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LUTHERAN HOMES SOCIETY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-01-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5816310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH276034311Medicaid
OH5816OtherLICENSE