Healthcare Provider Details

I. General information

NPI: 1932335239
Provider Name (Legal Business Name): LTAC INVESTORS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2009
Last Update Date: 09/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SCHOOL STREET
WINTERSVILLE OH
43953-9620
US

IV. Provider business mailing address

200 SCHOOL STREET
WINTERSVILLE OH
43953-9620
US

V. Phone/Fax

Practice location:
  • Phone: 740-346-2600
  • Fax: 740-346-2602
Mailing address:
  • Phone: 740-346-2600
  • Fax: 740-346-2602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number1493
License Number StateOH

VIII. Authorized Official

Name: MRS. SUSAN COLPO
Title or Position: CEO
Credential:
Phone: 740-346-2600