LOCUST RIDGE NURSING HOME INC
Alzheimer Center
Williamsburg, Ohio
Provider NPI: 1154419869
Organization Information:Organization Name: LOCUST RIDGE NURSING HOME INC
Practice Location:
12745 ELM CORNER RD WILLIAMSBURG, OH 45176 US
Tel: 937-444-2920 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
12745 ELM CORNER RD WILLIAMSBURG, OH 45176 US
Tel: 937-444-2920 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
X | 311500000X | Nursing & Custodial Care Facilities Alzheimer Center (Dementia Center) | OH | 0771N |
X | 313M00000X | Nursing & Custodial Care Facilities Nursing Facility/Intermediate Care Facility | OH | 0771N |
X | 314000000X | Nursing & Custodial Care Facilities Skilled Nursing Facility | OH | 0771N |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
0071952 | OH | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin