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Contact Information

OTTERBEIN MONCLOVA, LLC
5069 OTTERBEIN WAY
MONCLOVA, OH43542
 Phone: 419-878-0550
 Fax: 419-878-3169
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

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

NPI Profile & details for OTTERBEIN MONCLOVA, LLC

NPI # 1801919584
LBN Legal business name OTTERBEIN MONCLOVA, LLC
Authorized official JAMES GREEN - (TREASURER & CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 04/09/2007
Last updated 02/09/2015 - About 11 years ago
Identifiers
OH License # 2503N
OH Medicaid 2819454
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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