MEDICARE: HIGHBANKS CARE CENTER, LLC

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	314000000X	Skilled Nursing Facility	1942N	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588666788
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIGHBANKS CARE CENTER, LLC

Provider Business Mailing Address
First Line	:	782 W ORANGE RD
Second Line	:
City	:	DELAWARE
State	:	OH
Zip	:	43015-8922
Country	:	US
Telephone Number	:	330-204-1040
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 LAZELLE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43235-1419
Country	:	US
Telephone Number	:	614-888-2021
Fax Number	:	614-888-6710

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROBERT SPEELMAN
Credential	:
Telephone Number	:	330-204-1040

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	05/04/2018

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Directions to “HIGHBANKS CARE CENTER, LLC ” Practice Location

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