MEDICARE: OHIO LIVING HOLDINGS

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	251G00000X	Community Based Hospice Care Agency	0157HSP	OH

General Provider Information

NPI Number	:	1841688728
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OHIO LIVING HOLDINGS

Provider Business Mailing Address
First Line	:	25 INDIANA AVE
Second Line	:
City	:	MONROE
State	:	OH
Zip	:	45050-1146
Country	:	US
Telephone Number	:	513-681-8174
Fax Number	:	513-681-1850

Provider Business Practice Location Address
First Line	:	25 INDIANA AVE
Second Line	:
City	:	MONROE
State	:	OH
Zip	:	45050-1146
Country	:	US
Telephone Number	:	513-681-8174
Fax Number	:	513-681-1850

Authorized Official
Title or Position	:	CEO
Name	:	MR. LAURENCE C GUMINA
Credential	:
Telephone Number	:	614-888-7800

Provider Enumeration Date	:	12/31/2014
Last Update Date	:	01/27/2019

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