Provider Demographics
| NPI: | 1912305376 |
|---|---|
| Name: | WC-LANCASTER OPS, LLC |
| Entity type: | Organization |
| Organization Name: | WC-LANCASTER OPS, LLC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | EXECUTIVE DIRECTOR |
| Authorized Official - Prefix: | MS |
| Authorized Official - First Name: | ELIZABETH |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | KINNER |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 740-654-4422 |
| Mailing Address - Street 1: | 800 BECKS KNOB RD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | LANCASTER |
| Mailing Address - State: | OH |
| Mailing Address - Zip Code: | 43130-8802 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 740-654-4422 |
| Mailing Address - Fax: | 740-654-4422 |
| Practice Address - Street 1: | 800 BECKS KNOB RD |
| Practice Address - Street 2: | |
| Practice Address - City: | LANCASTER |
| Practice Address - State: | OH |
| Practice Address - Zip Code: | 43130-8802 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 740-654-4422 |
| Practice Address - Fax: | 740-654-4422 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2014-12-16 |
| Last Update Date: | 2014-12-16 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| OH | 2061R | 310400000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility |