Friends Of Good Shepherd Manor

LBN: Friends Of Good Shepherd Manor
Friends Of Good Shepherd Manor is an health care organization with primary practice located at 374 Good Manor Rd. , Lucasville OH 45648-1029. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities. Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities is the primary health care specialty. Friends Of Good Shepherd Manor can be contacted via phone (740) 289-2861, or through Bowling, Jackie Brenda via phone (740) 289-2861.

Contact Information

Primary practice address
374 Good Manor Rd. Lucasville OH 45648-1029
Phone: (740) 289-2861
Fax: (740) 289-3916
Website:
Map and Directions
Authorized official contact:
Name: Bowling, Jackie Brenda
Phone: (740) 289-2861

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X 6610055 Ohio
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X 6610153 Ohio
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X 6610306 Ohio
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320900000X 6600173 Ohio

Profile Details

NPI number 1912110925
LBN Legal business name Friends Of Good Shepherd Manor
DBA Doing business as
Authorized official Bowling, Jackie Brenda
Entity Organization
Organization subpart 1 No
Enumeration date May 7th, 2007
Last updated Feb 11th, 2009 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912110925 NPPES
Ohio MEDICAID 0830364

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