Healthcare Provider Details

I. General information

NPI: 1790133023
Provider Name (Legal Business Name): LIMA ACRES NURSING & REHABILITATION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2016
Last Update Date: 11/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

599 S SHAWNEE ST
LIMA OH
45804-1461
US

IV. Provider business mailing address

100 ROUTE 70 STE 3
LAKEWOOD NJ
08701-7406
US

V. Phone/Fax

Practice location:
  • Phone: 419-227-2154
  • Fax:
Mailing address:
  • Phone: 732-659-1353
  • Fax:

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: JACOB STERN
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 732-659-1353