Organization
TANDEM HEALTH CARE OF LUCASVILLE I, INC.
Active
Other names
Edgewood of Lucasville I
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH CONTE (CHIEF OPERATING OFFICER)
(407) 571-1550
Entity
Organization
Contact information
Practice address
10098 BIG BEAR CREEK ROAD, LUCASVILLE, OH 45648-0789
(740) 259-5536
(740) 259-2531
Mailing address
800 CONCOURSE PKWY S, SUITE 200, MAITLAND, FL 32751-6148
(407) 571-1550
(407) 571-1599
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1761N
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2148750
—
OH
Enumeration date
06/28/2006
Last updated
08/22/2020
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