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NPI Code Detail

MEDICARE: LIMA CARE COMMUNITY OPCO LLC

MEDICARE: LIMA CARE COMMUNITY OPCO LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1568394542
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIMA CARE COMMUNITY OPCO LLC
Provider Business Mailing Address
First Line : 5910 LANDERBROOK DR STE 150
Second Line :
City : MAYFIELD HEIGHTS
State : OH
Zip : 44124-6506
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2440 BATON ROUGE
Second Line :
City : LIMA
State : OH
Zip : 45805-5104
Country : US
Telephone Number : 330-620-7828
Fax Number :
Authorized Official
Title or Position : CHIEF OPERATING OFFICER
Name : JEFFREY DE
Credential :
Telephone Number : 330-620-7828
Provider Enumeration Date : 06/02/2026
Last Update Date : 06/02/2026

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Directions to “LIMA CARE COMMUNITY OPCO LLC ” Practice Location

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