Provider Demographics
NPI:1013904226
Name:COUNTY OF LOGAN OFFICE OF AUDITOR
Entity Type:Organization
Organization Name:COUNTY OF LOGAN OFFICE OF AUDITOR
Other - Org Name:LOGAN ACRES CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GILMORE
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:937-592-2901
Mailing Address - Street 1:2739 COUNTY ROAD 91
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTAINE
Mailing Address - State:OH
Mailing Address - Zip Code:43311-9007
Mailing Address - Country:US
Mailing Address - Phone:937-592-2901
Mailing Address - Fax:937-592-2763
Practice Address - Street 1:2739 COUNTY ROAD 91
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-9007
Practice Address - Country:US
Practice Address - Phone:937-592-2901
Practice Address - Fax:937-592-2763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0299734Medicaid
OH2671032Medicaid
OH0299734Medicaid