Provider Demographics
NPI:1316501885
Name:OHIO LIVING COMMUNITIES
Entity type:Organization
Organization Name:OHIO LIVING COMMUNITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE MANAGER OF MANAGED CARE
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:PERKINS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:614-888-7800
Mailing Address - Street 1:1001 KINGSMILL PKWY
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-1129
Mailing Address - Country:US
Mailing Address - Phone:614-888-7800
Mailing Address - Fax:614-888-6864
Practice Address - Street 1:303 N MECCA ST
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:OH
Practice Address - Zip Code:44410-1074
Practice Address - Country:US
Practice Address - Phone:330-638-2420
Practice Address - Fax:330-638-1028
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OHIO LIVING COMMUNITIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2717073Medicaid