Provider Demographics
NPI:1982852125
Name:LUTHREAN VILLAGE OF ASHLAND
Entity Type:Organization
Organization Name:LUTHREAN VILLAGE OF ASHLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-281-8403
Mailing Address - Street 1:330 DAVIS RD
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-4401
Mailing Address - Country:US
Mailing Address - Phone:419-281-8403
Mailing Address - Fax:419-207-0353
Practice Address - Street 1:330 DAVIS RD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-4401
Practice Address - Country:US
Practice Address - Phone:419-281-8403
Practice Address - Fax:419-207-0353
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LUTHERAN SOCIAL SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-29
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5885310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility