Provider Demographics
NPI:1851881825
Name:HOUSE OF LORETO FOR SENIOR CITIZENS
Entity Type:Organization
Organization Name:HOUSE OF LORETO FOR SENIOR CITIZENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSING HOME ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SISTER JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:HAROLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-453-8137
Mailing Address - Street 1:2812 HARVARD AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-3155
Mailing Address - Country:US
Mailing Address - Phone:330-453-8137
Mailing Address - Fax:330-453-8140
Practice Address - Street 1:2812 HARVARD AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44709-3155
Practice Address - Country:US
Practice Address - Phone:330-453-8137
Practice Address - Fax:330-453-8140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH85314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility