Organization
LUCASVILLE II FACILITY OPERATIONS, LLC
Active
Other names
Edgewood Manor of Lucasville II
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS L. BARR (EXECUTIVE DIRECTOR)
(740) 259-2351
Entity
Organization
Contact information
Practice address
10098A BIG BEAR CREEK ROAD, LUCASVILLE, OH 45648-0789
(740) 259-2351
(740) 259-9061
Mailing address
10098A BIG BEAR CREEK RD, LUCASVILLE, OH 45648-9168
(740) 259-2351
(740) 259-0631
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2710034
—
OH
Enumeration date
07/28/2006
Last updated
02/22/2017
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