Provider Demographics
NPI:1013024355
Name:LO HAR LODGE INC
Entity type:Organization
Organization Name:LO HAR LODGE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT COMPLIANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:FURMANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RHIT
Authorized Official - Phone:619-441-8771
Mailing Address - Street 1:794 DOROTHY ST
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92019-3101
Mailing Address - Country:US
Mailing Address - Phone:619-444-8270
Mailing Address - Fax:619-444-0872
Practice Address - Street 1:794 DOROTHY ST
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92019-3101
Practice Address - Country:US
Practice Address - Phone:619-444-8270
Practice Address - Fax:619-444-0872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374600599311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)