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Contact Information

DEACONESS LONG TERM CARE OF OHIO, INC.
127 MENTZER DR
CONVOY, OH45832
 Phone: 419-749-2194
 Fax: 419-749-2424
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for DEACONESS LONG TERM CARE OF OHIO, INC.

NPI Number 1043203722
LBN Legal business name DEACONESS LONG TERM CARE OF OHIO, INC.
Authorized official CARLA BROOKS - (CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 08/26/2005
Last updated 08/22/2020 - About 6 years ago
Identifiers
OH License # 1767N
OH Medicaid 0214771
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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