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General NPI Number Information
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NPI Number | 1053353276
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Entity Type | Organization
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Legal Business Name | LIMA CONVALESCENT HOME FOUNDATION INCORPORATED
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | 1650 ALLENTOWN RD
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City | LIMA
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State | OH
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Zip | 45805
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Country | US
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Telephone | 419-224-9741
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Fax | 419-224-2761
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Provider Business Mailing Address
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Address Line | 1650 ALLENTOWN RD
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City | LIMA
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State | OH
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Zip | 45805
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Country | US
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Telephone | 419-224-9741
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Fax | 419-224-2761
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JESSICA TRINKO
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Credential |
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Telephone | 419-224-9741
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 1539
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License Number State | OH
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