Provider Demographics
NPI:1336187368
Name:COUNTY OF LORAIN OHIO
Entity Type:Organization
Organization Name:COUNTY OF LORAIN OHIO
Other - Org Name:GOLDEN ACRES LORAIN COUNTY NURSING HOME
Other - Org Type:Other Name
Authorized Official - Title/Position:NURSING HOME ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JERI
Authorized Official - Middle Name:
Authorized Official - Last Name:DULL
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:440-988-2322
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001-0190
Mailing Address - Country:US
Mailing Address - Phone:440-988-2322
Mailing Address - Fax:440-988-2932
Practice Address - Street 1:45999 N RIDGE RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001-1779
Practice Address - Country:US
Practice Address - Phone:440-988-2322
Practice Address - Fax:440-988-2932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0700745Medicaid
OH0700745Medicaid