Organization
LISBON SKILLED NURSING AND RESIDENTIAL CARE, LLC
Active
Other names
Continuing Healthcare of Lisbon, THE VISTA CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENJAMIN PARSONS (SECRETARY)
(216) 772-1105
Entity
Organization
Contact information
Practice address
100 VISTA DR, LISBON, OH 44432-1008
(330) 424-5852
Mailing address
2875 CENTER RD STE 6, BRUNSWICK, OH 44212-2319
(216) 772-1105
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
2090R
OH
314000000X
Skilled Nursing Facility
Primary
2090N
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000321362
ANTHEM
OH
01
—
155884375
MEDICAID ASSISTED LIVING WAIVER
OH
05
—
2434646
—
OH
Enumeration date
09/30/2005
Last updated
01/26/2023
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