Healthcare Provider Details

I. General information

NPI: 1407244387
Provider Name (Legal Business Name): OHIO LIVING HOLDINGS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2014
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 N MILLER RD STE 101
FAIRLAWN OH
44333-3729
US

IV. Provider business mailing address

9200 WORTHINGTON RD STE 300
WESTERVILLE OH
43082-7240
US

V. Phone/Fax

Practice location:
  • Phone: 330-873-3468
  • Fax: 330-873-3465
Mailing address:
  • Phone: 614-888-7800
  • Fax: 148-886-8646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number0157HSP
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number0244HSP
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LAURENCE C GUMINA
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 614-888-7800