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MANSFIELD LIVING CENTER LTD NPI 1063409720

NPI Profile

NPI: 1063409720
Provider Name: MANSFIELD LIVING CENTER, LTD

Doing Business As: TWIN OAKS LIVING & LEARNING CENTER

Classification: Intermediate Care Facility, Mentally Retarded - 315P00000X
Entity Type: Organization
Address:
73 MADISON RD
MANSFIELD, OH
ZIP 44905
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Phone: (419) 526-0124

MANSFIELD LIVING CENTER, LTD is an intermediate care facility mentally retarded in Mansfield, OH. The provider is (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. MANSFIELD LIVING CENTER, LTD NPI is 1063409720. The provider is registered as an organization entity type.
The provider Is Doing Business As Twin Oaks Living & Learning Center.

The provider's business location address is:

73 MADISON RD
MANSFIELD, OH
ZIP 44905-830
Phone: (419) 526-0124
Fax: (419) 522-4391

The provider's authorized official is Tracy R Robertson .
The authorized official title is Corp. Office Executive Assistant and has the following contact phone number (419) 526-0124.

The enumeration date for this NPI number is 9/28/2005 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1315P00000XIntermediate Care Facility, Mentally Retarded15637OHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12076435MEDICAIDOHIO
236G045MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 12/11/2019

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