Provider Demographics
NPI:1245262799
Name:LUTHERAN HOMES SOCIETY, INC.
Entity type:Organization
Organization Name:LUTHERAN HOMES SOCIETY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:LORINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHALK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-861-4906
Mailing Address - Street 1:2411 SEAMAN ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43605-1519
Mailing Address - Country:US
Mailing Address - Phone:419-693-1520
Mailing Address - Fax:419-693-3295
Practice Address - Street 1:1905 PERRYSBURG HOLLAND RD
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:OH
Practice Address - Zip Code:43528-9582
Practice Address - Country:US
Practice Address - Phone:419-693-1520
Practice Address - Fax:419-693-3295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH10210OtherMACSIS IDENTIFIER