Healthcare Provider Details

I. General information

NPI: 1285049403
Provider Name (Legal Business Name): LP CHILLICOTHE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2014
Last Update Date: 04/04/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 MARIETTA RD
CHILLICOTHEE OH
45601-9433
US

IV. Provider business mailing address

60 MARIETTA RD
CHILLICOTHEE OH
45601-9433
US

V. Phone/Fax

Practice location:
  • Phone: 740-772-5900
  • Fax: 740-773-3946
Mailing address:
  • Phone: 740-772-5900
  • Fax: 740-773-3946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: JOHN HARRISON
Title or Position: CFO
Credential:
Phone: 502-568-7800