Provider Demographics
NPI:1366438368
Name:OHIO LIVING COMMUNITIES
Entity type:Organization
Organization Name:OHIO LIVING COMMUNITIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:C
Authorized Official - Last Name:GUMINA
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:614-888-7800
Mailing Address - Street 1:9200 WORTHINGTON RD STE 300
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-7240
Mailing Address - Country:US
Mailing Address - Phone:614-888-7800
Mailing Address - Fax:614-888-6864
Practice Address - Street 1:1150 W MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-7129
Practice Address - Country:US
Practice Address - Phone:330-867-2150
Practice Address - Fax:330-867-1642
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OHIO LIVING COMMUNITIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-25
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1280N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000216383OtherANTHEM BC/BS
OH0025789Medicaid
OH365051Medicare Oscar/Certification