New Lebanon SNF, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

NEW LEBANON SNF, LLC

Practice address

101 Mills PL
New Lebanon, OH 45345-1430

Phone

(312) 590-1055

NPI assigned

Jun 12, 2019

Organization subpart

No

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

Authorized official

Name

Yair Zuckerman

Title

Ceo

Phone

(312) 590-1055

Specialties & licenses 1

Addresses

Other names 2

• Illuminate HC New Lebanon Doing business as
• SKLD New Lebanon Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560297600000",
    "number": "1982263984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 DAVIS ST STE 200",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MILLS PL",
            "city": "NEW LEBANON",
            "state": "OH",
            "postal_code": "453451430",
            "telephone_number": "312-590-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LEBANON SNF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A",
        "authorized_official_last_name": "ZUCKERMAN",
        "authorized_official_first_name": "YAIR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "312-590-1055"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Illuminate HC New Lebanon",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SKLD New Lebanon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pamela Michael
• Diane Michelle Munafo, LPT
• Johnny W Myers
• New Lebanon Local School District
• New Lebanon Rehabilitation and Healthcare Center LLC
• Kingsley Orock, PHARM.D
• Kiara M Overholtz
• Dylan Michael-James Parrish
• Primary Care Associates of New Lebanon, LLC
• Tabitha Qualls

• Skilled Nursing Facility in New Lebanon, OH
• Providers in New Lebanon, 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 Jun 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.