SHEPHERD OF THE VALLEY LUTHERAN RETIREMENT SERVICES INC. NPI 1215573431

NPI Information

NPI: 1215573431
Provider Name: SHEPHERD OF THE VALLEY LUTHERAN RETIREMENT SERVICES, INC.
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 36D2035124

Address:
4100 N RIVER RD NE
WARREN, OH
ZIP 44484
Phone: (330) 856-9232
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SHEPHERD OF THE VALLEY LUTHERAN RETIREMENT SERVICES, INC. is an assisted living facility in Warren, OH. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. SHEPHERD OF THE VALLEY LUTHERAN RETIREMENT SERVICES, INC. NPI is 1215573431. The provider is registered as an organization entity type.

The provider's business location address is:

4100 N RIVER RD NE
WARREN, OH
ZIP 44484-041
Phone: (330) 856-9232
Fax: (330) 856-2571

The provider's authorized official is Victoria Brown .
The authorized official title is Chief Financial Officer and has the following contact phone number (330) 530-4038.

The CLIA number assigned to this NPI record is 36D2035124 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/22/2019 and was last updated on 11/22/2019.

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	310400000X	Assisted Living Facility				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	0375874	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

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