Provider Demographics
NPI:1316911407
Name:LIVING CARE ALTERNATIVES OF KIRKERSVILLE INC
Entity type:Organization
Organization Name:LIVING CARE ALTERNATIVES OF KIRKERSVILLE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROSSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-890-2900
Mailing Address - Street 1:855 S SUNBURY RD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081
Mailing Address - Country:US
Mailing Address - Phone:614-890-2900
Mailing Address - Fax:614-898-1993
Practice Address - Street 1:205 E MAIN ST
Practice Address - Street 2:
Practice Address - City:KIRKERSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43033
Practice Address - Country:US
Practice Address - Phone:740-927-3209
Practice Address - Fax:740-927-4822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-15
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4176313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH6948503Medicaid
OH6948503Medicaid