Provider Demographics
NPI:1992859235
Name:OAK HILLS MANOR LLC
Entity Type:Organization
Organization Name:OAK HILLS MANOR LLC
Other - Org Name:OAKHILL MANOR CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:HANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-658-1462
Mailing Address - Street 1:4466 LYNNHAVEN AVENUE, NE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44641-9513
Mailing Address - Country:US
Mailing Address - Phone:330-875-5060
Mailing Address - Fax:
Practice Address - Street 1:4466 LYNNHAVEN AVENUE, NE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:OH
Practice Address - Zip Code:44641-9513
Practice Address - Country:US
Practice Address - Phone:330-875-5060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0480N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2458620Medicaid
OH2458620Medicaid