Provider Demographics
NPI:1952799835
Name:OHIO LIVING HOLDINGS
Entity Type:Organization
Organization Name:OHIO LIVING HOLDINGS
Other - Org Name:OHIO LIVING HOSPICE - GREATER CLEVELAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:STILLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-888-7800
Mailing Address - Street 1:9200 WORTHINGTON RD STE 300
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-7240
Mailing Address - Country:US
Mailing Address - Phone:614-888-7800
Mailing Address - Fax:148-886-8646
Practice Address - Street 1:36500 EUCLID AVE
Practice Address - Street 2:SUITE 152
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094
Practice Address - Country:US
Practice Address - Phone:440-953-1256
Practice Address - Fax:440-953-0870
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OHIO LIVING HOLDINGS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-12-31
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0157HSP251G00000X
251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0221039Medicaid