MEDICARE: LORCI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1194194753
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LORCI

Provider Business Mailing Address
First Line	:	3148 GRILL RD
Second Line	:
City	:	NEW FRANKLIN
State	:	OH
Zip	:	44216-9381
Country	:	US
Telephone Number	:	330-701-4114
Fax Number	:

Provider Business Practice Location Address
First Line	:	3148 GRILL RD
Second Line	:
City	:	NEW FRANKLIN
State	:	OH
Zip	:	44216-9381
Country	:	US
Telephone Number	:	330-701-4114
Fax Number	:

Authorized Official
Title or Position	:	CPC
Name	:	KENNETH WAYNE HUFFMAN
Credential	:	LICDC
Telephone Number	:	330-701-4114

Provider Enumeration Date	:	09/24/2015
Last Update Date	:	09/24/2015

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Directions to “LORCI ” Practice Location

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