Provider Demographics
NPI:1700125515
Name:MERIT HOUSE LLC.
Entity Type:Organization
Organization Name:MERIT HOUSE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:419-478-5131
Mailing Address - Street 1:4645 LEWIS AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43612-2336
Mailing Address - Country:US
Mailing Address - Phone:419-478-5131
Mailing Address - Fax:419-470-0043
Practice Address - Street 1:4645 LEWIS AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43612-2336
Practice Address - Country:US
Practice Address - Phone:419-478-8208
Practice Address - Fax:419-470-0043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-14
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0079825Medicaid
OH365279Medicare PIN
OH365279Medicare Oscar/Certification
OH365279Medicare UPIN