NPIMap

Organization Active NPI

Friends of Good Shepherd Manor

  • Intellectual Disabilities Intermediate Care Facility
  • Lucasville, OH
National Provider Identifier
1134368459
Registry record updated Feb 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
FRIENDS OF GOOD SHEPHERD MANOR
Practice address
374 Good Manor Rd
Lucasville, OH 45648
Phone
(740) 289-2861
Fax
(740) 289-4355
NPI assigned
Feb 10, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2009

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

Authorized official

Name
Ms. Jackie Bowling
Title
Executive Director
Phone
(740) 289-2861

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

374 Good Manor Rd
Lucasville, OH 45648

Mailing address

374 Good Manor Rd
PO Box 1029
Lucasville, OH 45648
Phone (740) 289-2861

Other identifiers 1

IdentifierTypeStateIssuer
2234344MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
Friends of Good Shepherd Manor3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1234224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234224000000",
    "number": "1134368459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 GOOD MANOR RD",
            "address_2": "PO BOX 1029",
            "city": "LUCASVILLE",
            "state": "OH",
            "postal_code": "45648",
            "telephone_number": "740-289-2861",
            "fax_number": "740-289-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 GOOD MANOR RD",
            "city": "LUCASVILLE",
            "state": "OH",
            "postal_code": "45648",
            "telephone_number": "740-289-2861",
            "fax_number": "740-289-4355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRIENDS OF GOOD SHEPHERD MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-10",
        "last_updated": "2009-02-10",
        "status": "A",
        "authorized_official_last_name": "BOWLING",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "740-289-2861",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2234344",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lucasville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2009; 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.