Good Shepherd Home
Organization Active NPI Assisted Living Facility · Fostoria, OH
NPI 1124687181 · NPPES record last updated Jun 12, 2019
Key facts
- NPI
- 1124687181
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Assisted Living Facility 310400000X
- Legal business name
- GOOD SHEPHERD HOME
- Practice address
- 725 Columbus Ave
Fostoria, OH 44830-3255 - Phone
- (419) 937-1801
- Fax
- (419) 937-1800
- NPI assigned
- Jun 12, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- 0982N
Authorized official
- Name
- Christopher P Widman
- Title
- Executive Director
- Phone
- (419) 937-1801
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- Good Shepherd Home
- Part of
- Good Shepherd Home
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | Yes |
Addresses
Primary practice location
725 Columbus Ave
Fostoria, OH 44830-3255
Mailing address
725 Columbus Ave
Fostoria, OH 44830-3255
Phone (419) 937-1801
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3293921 | Medicaid | OH |
Other names
- Good Shepherd Home Assisted Living
Other providers in Fostoria, OH
- Jessica Caitlin Gagen
- Bridget Gallegos
- Carolyn R. Garcia
- Sierra Garcia
- Julienne Elizabeth Garlock
- Good Shepherd Home
- Good Shepherd Home
- Tonia Marie Groves
- Gayle D Guernsey
- Thomas C Guernsey
All providers in Fostoria, OH · Assisted Living Facility in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.