Provider Demographics
NPI:1649471210
Name:OHIO LIVING HOLDINGS
Entity type:Organization
Organization Name:OHIO LIVING HOLDINGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:C
Authorized Official - Last Name:GUMINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-888-7800
Mailing Address - Street 1:5810 SOUTHWYCK BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-1518
Mailing Address - Country:US
Mailing Address - Phone:419-865-1499
Mailing Address - Fax:419-865-4227
Practice Address - Street 1:5810 SOUTHWYCK BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-1518
Practice Address - Country:US
Practice Address - Phone:419-865-1499
Practice Address - Fax:419-865-4227
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OHIO LIVING HOLDINGS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-30
Last Update Date:2019-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH411852OtherPASSPORT PROVIDER NUMBER