Mansfield Living Center, LTD

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

15637 Issued in OH

Legal business name

MANSFIELD LIVING CENTER, LTD

Practice address

73 Madison Rd
Mansfield, OH 44905-2830

Phone

(419) 526-0124

Fax

(419) 522-4391

NPI assigned

Sep 28, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Tracy R Robertson

Title

Corp. Office Executive Assistant

Phone

(419) 526-0124

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• TWIN OAKS LIVING & LEARNING CENTER Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063409720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 MADISON RD",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449052830",
            "telephone_number": "419-526-0124",
            "fax_number": "419-522-4391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 MADISON RD",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449052830",
            "telephone_number": "419-526-0124",
            "fax_number": "419-522-4391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANSFIELD LIVING CENTER, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CORP. OFFICE EXECUTIVE ASSISTANT",
        "authorized_official_telephone_number": "419-526-0124",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "OH",
            "license": "15637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2076435",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TWIN OAKS LIVING & LEARNING CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mansfield Orthopaedic Surgery & Rheumatology Inc

• Intellectual Disabilities Intermediate Care Facility in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Intellectual Disabilities Intermediate Care Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.