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Organization

LUCASVILLE I FACILITY OPERATIONS, LLC

Active
Other names
Edgewood Manor of Lucasville I
Organization subpart
No

Provider details

NPI number
Authorized official
THOMAS L. BARR (EXECUTIVE DIRECTOR)
(740) 259-5536
Entity
Organization

Contact information

Practice address
10098 BIG BEAR CREEK ROAD, LUCASVILLE, OH 45648-0789
(740) 259-5536
(740) 259-2531
Mailing address
10098 BIG BEAR CREEK RD, LUCASVILLE, OH 45648-9168
(740) 259-5536
(740) 259-2531

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2708083
OH
Enumeration date
07/26/2006
Last updated
02/22/2017
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