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General NPI Number Information
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NPI Number | 1124906581
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Entity Type | Organization
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Legal Business Name | OTTERBEIN LEBANON RETIREMENT LIVING COMMUNITY
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 585 N STATE ROUTE 741
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City | LEBANON
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State | OH
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Zip | 45036-3313
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Country | US
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Telephone | 513-696-8567
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Fax |
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Provider Business Mailing Address
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Address Line | 3855 LOWER MARKET ST STE 300
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City | LEBANON
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State | OH
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Zip | 45036-7654
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Country | US
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Telephone | 513-933-5401
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | JAMES GREEN
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Credential | CPA
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Telephone | 513-933-5418
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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