Provider Demographics
NPI:1851695415
Name:LUTHERAN HOMES SOCIETY, INC.
Entity Type:Organization
Organization Name:LUTHERAN HOMES SOCIETY, INC.
Other - Org Name:LUTHERAN HOME AT TOLEDO
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 1:2021 N MCCORD RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-3030
Mailing Address - Country:US
Mailing Address - Phone:419-861-5500
Mailing Address - Fax:
Practice Address - Street 1:131 N WHEELING ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43605-1544
Practice Address - Country:US
Practice Address - Phone:419-724-1414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-22
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000323842OtherANTHEM BC/BS
OH3108309Medicaid
OH3108309Medicaid