Organization
LUTHER HOME OF MERCY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD WUKOTICH (EXECUTIVE DIRECTOR)
(419) 725-5226
Entity
Organization
Contact information
Practice address
5810 N MAIN, WILLISTON, OH 43468
(419) 725-5225
(419) 836-9238
Mailing address
5810 NORTH MAIN ST., P O BOX 187, WILLISTON, OH 43468
(419) 725-5225
(419) 836-9238
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
1575
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0035287
—
OH
05
—
M6200364
—
OH
Enumeration date
02/24/2006
Last updated
08/22/2020
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