Lorain Manor, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0763 Issued in OH

Legal business name

LORAIN MANOR, INC.

Doing business as

Main Street Care Center

Practice address

500 Community Drive
Avon Lake, OH 44012

Phone

(440) 930-6600

Fax

(440) 930-1801

NPI assigned

Oct 25, 2005

Organization subpart

No

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

Authorized official

Name

Mark Sprenger

Title

Executive VP and Cio

Phone

(440) 989-5234

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Main Street Care Center Doing business as

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710977376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 COMMUNITY DRIVE",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "44012",
            "telephone_number": "440-930-6600",
            "fax_number": "440-930-1801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 COMMUNITY DRIVE",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "44012",
            "telephone_number": "440-930-6600",
            "fax_number": "440-930-1801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LORAIN MANOR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SPRENGER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "EXECUTIVE VP AND CIO",
        "authorized_official_telephone_number": "440-989-5234"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "0763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0423090",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2726189",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000156480",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PT",
            "identifier": "000000357006",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM OT",
            "identifier": "000000357010",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM ST",
            "identifier": "000000357011",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Main Street Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Catherine May Lakis, R.N.
• Landings Family & Psychological Center, Inc.
• Ashley Langer, FNP- BC
• Taylor Michelle Leube, M.A., CCC-SLP
• Rebecca Lightfoot
• Rachel Lovati, PT DPT
• Lisa A Loveless, OTR/L
• Christin Lucas
• Main Street Care Center, LTD.
• Christina D Makowski, M.A.,CCC-SLP

• Skilled Nursing Facility in Avon Lake, OH
• Providers in Avon Lake, OH by specialty
• Skilled Nursing 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.