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NPI Code Detail

MEDICARE: LOST CREEK CARE CENTER

MEDICARE: LOST CREEK CARE CENTER
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
1314000000XSkilled Nursing Facility005613OH

General Provider Information

NPI Number : 1689964306
Entity Type Code : Organization
Provider Name (Legal Business Name) : LOST CREEK CARE CENTER
Provider Business Mailing Address
First Line : 804 S MUMAUGH RD
Second Line :
City : LIMA
State : OH
Zip : 45804-3569
Country : US
Telephone Number : 567-712-7569
Fax Number :
Provider Business Practice Location Address
First Line : 804 S MUMAUGH RD
Second Line :
City : LIMA
State : OH
Zip : 45804-3569
Country : US
Telephone Number : 567-712-7569
Fax Number :
Authorized Official
Title or Position : OCCUPATIONAL THERAPIST
Name : DIONNA NOONAN
Credential : OTR/L
Telephone Number : 614-563-4713
Provider Enumeration Date : 04/14/2011
Last Update Date : 04/14/2011

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Directions to “LOST CREEK CARE CENTER ” Practice Location

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