Organization
ANCHOR LODGE NURSING HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH WIEDENMANNOTT (EX MEDICARE SPECIALIST)
(440) 989-5238
Entity
Organization
Contact information
Practice address
3756 W ERIE AVE, LORAIN, OH 44053-1292
(440) 244-2019
(440) 244-5612
Mailing address
3756 W ERIE AVE, LORAIN, OH 44053-1292
(440) 244-2019
(440) 244-5612
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0556N
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000156341
ANTHEM
OH
01
—
000000357080
ANTHEM PT
OH
01
—
000000357081
ANTHEM OT
OH
01
—
000000357082
ANTHEM ST
OH
05
—
0072442
—
OH
Enumeration date
10/24/2005
Last updated
04/07/2015
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