Otterbein Lebanon Retirement Living Community
Organization Active NPI Nursing Facility/Intermediate Care Facility · Lebanon, OH
NPI 1942595640 · NPPES record last updated Jun 14, 2011
Key facts
- NPI
- 1942595640
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nursing Facility/Intermediate Care Facility 313M00000X
- Legal business name
- OTTERBEIN LEBANON RETIREMENT LIVING COMMUNITY
- Practice address
- 580 N State Route 741
Lebanon, OH 45036-8839 - Phone
- (513) 933-5400
- Fax
- (513) 932-1054
- NPI assigned
- Jun 10, 2011
- Organization subpart
- Yes
- Parent organization (as reported)
- OTTERBEIN HOMES
Authorized official
- Name
- Chris Green
- Title
- Chief Financial Officer
- Phone
- (513) 933-5400
Corporate family (same tax ID) 3
National Provider Directory
- Tax ID family
- Otterbein Lebanon Retirement Living Community
- Part of
- Otterbein Lebanon Retirement Living Community
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | |||
| Adult Care Home Facility | 311ZA0620X | |||
| Nursing Facility/Intermediate Care Facility | 313M00000X | Yes |
Addresses
Primary practice location
580 N State Route 741
Lebanon, OH 45036-8839
Mailing address
585 N State Route 741
Lebanon, OH 45036-8840
Phone (513) 933-5444
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6636331 | Medicaid | OH |
Other providers in Lebanon, OH
- Otterbein Home Health, LLC
- Otterbein Hospice LLC
- Otterbein Lebanon
- Otterbein Lebanon
- Otterbein Lebanon Retirement Living Community
- Paul John Ottke
- Kasi Owens
- Tiffany Owens
- Brandon Page
- Palarum, LLC
All providers in Lebanon, OH · Nursing Facility/Intermediate Care 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 14, 2011. 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.