FRIENDS OF GOOD SHEPHERD MANOR NPI 1134368459

NPI Information

NPI: 1134368459
Provider Name: FRIENDS OF GOOD SHEPHERD MANOR
Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
374 GOOD MANOR RD
LUCASVILLE, OH
ZIP 45648
Phone: (740) 289-2861
Get Directions

FRIENDS OF GOOD SHEPHERD MANOR is an intermediate care facility mentally retarded in Lucasville, OH. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. FRIENDS OF GOOD SHEPHERD MANOR NPI is 1134368459. The provider is registered as an organization entity type.

The provider's business location address is:

374 GOOD MANOR RD
LUCASVILLE, OH
ZIP 45648
Phone: (740) 289-2861
Fax: (740) 289-4355

The provider's authorized official is Jackie Bowling .
The authorized official title is Executive Director and has the following contact phone number (740) 289-2861.

The enumeration date for this NPI number is 2/10/2009 and was last updated on 2/10/2009.

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
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities				Yes

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
1	2234344	MEDICAID	OHIO

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: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »