MEDICARE: LOTT INDUSTRIES INCORPORATED

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	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1871100495
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOTT INDUSTRIES INCORPORATED

Provider Business Mailing Address
First Line	:	3350 HILL AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43607-2937
Country	:	US
Telephone Number	:	419-276-4658
Fax Number	:

Provider Business Practice Location Address
First Line	:	3350 HILL AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43607-2937
Country	:	US
Telephone Number	:	419-381-5200
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TIMOTHY DEAN MENKE
Credential	:	MBA
Telephone Number	:	419-276-4658

Provider Enumeration Date	:	09/28/2020
Last Update Date	:	09/28/2020

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