ST. LUKE LUTHERAN COMMUNITY - PORTAGE LAKES NPI 1629665146

NPI Information

NPI: 1629665146
Provider Name: ST. LUKE LUTHERAN COMMUNITY - PORTAGE LAKES
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 36D0341034

Address:
615 LATHAM LN
NEW FRANKLIN, OH
ZIP 44319
Phone: (330) 644-3914
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ST. LUKE LUTHERAN COMMUNITY - PORTAGE LAKES is an assisted living facility in New Franklin, 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. ST. LUKE LUTHERAN COMMUNITY - PORTAGE LAKES NPI is 1629665146. The provider is registered as an organization entity type.

The provider's business location address is:

615 LATHAM LN
NEW FRANKLIN, OH
ZIP 44319-338
Phone: (330) 644-3914
Fax: (330) 644-8966

The provider's authorized official is Joyce L Mohler .
The authorized official title is Cfo and has the following contact phone number (330) 499-8341.

The CLIA number assigned to this NPI record is 36D0341034 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/30/2020 and was last updated on 12/30/2020.

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	2444797	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: 5/5/2024

NPI Synchronization or Removal

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