Provider Demographics
NPI:1720207574
Name:JOSINA LOTT RESIDENTIAL & COMMUNITY SERVICES
Entity Type:Organization
Organization Name:JOSINA LOTT RESIDENTIAL & COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-866-9013
Mailing Address - Street 1:120 S HOLLAND SYLVANIA RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-5622
Mailing Address - Country:US
Mailing Address - Phone:419-866-9013
Mailing Address - Fax:419-866-8428
Practice Address - Street 1:120 S HOLLAND SYLVANIA RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-5622
Practice Address - Country:US
Practice Address - Phone:419-866-9013
Practice Address - Fax:419-866-8428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0415545Medicaid