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General NPI Number Information
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NPI Number | 1154419869
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Entity Type | Organization
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Legal Business Name | LOCUST RIDGE NURSING HOME INC
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 12745 ELM CORNER RD
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City | WILLIAMSBURG
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State | OH
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Zip | 45176-9621
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Country | US
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Telephone | 937-444-2920
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Fax | 937-444-1009
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Provider Business Mailing Address
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Address Line | 12745 ELM CORNER RD
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City | WILLIAMSBURG
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State | OH
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Zip | 45176-9621
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Country | US
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Telephone | 937-444-2920
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Fax | 937-444-1009
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Authorized Official
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Title or Position | BOARD OF DIRECTOR
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Name | PATRICIA A MEEKER
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Credential |
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Telephone | 513-797-5144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 0771N
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 0771N
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number | 0771N
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License Number State | OH
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