OTTERBEIN LEBANON (NPI# 1164085577) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164085577 |
| Entity Type | Organization |
| Organization Name | OTTERBEIN LEBANON |
| Practice Address |
585 North State Route 741 Lebanon OH 45036-8839 |
| Mailing Address |
580 North State Route 741 Lebanon OH 45036-8839 |
| Practice Telephone | 5139335400 |
| Mailing Telephone | 5139335401 |
| Mailing Fax Number | 5139321054 |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2019-04-22 |
| Authorized Official Name | JAMES CHRIS GREEN (TREASURER & CFO) |
| Authorized Official Telephone | 5139335418 |
| Is Organization Subpart | Y |
| Parent Organization Name | OTTERBEIN LEBANON |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Otterbein Lebanon Assisted Living | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992797328 | Otterbein Lebanon | Skilled Nursing Facility | 585 N State Route 741, Lebanon, OH 45036-8840 | 2005-08-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | OTTERBEIN LEBANON | 585 N State Route 741, Lebanon, OH 45036-8840 |
| Street Address |
585 NORTH STATE ROUTE 741 |
| City | LEBANON |
| State | OH |
| Zip Code | 45036-8839 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205479458 | Natasha Denney Arentz | Nurse Practitioner | 5787 Oh-63, Lebanon, OH 45036 | 2019-10-21 |
| 1265086573 | Eric Stone | Counselor | 5234 Oh-63, Lebanon, OH 45036 | 2019-07-25 |
| 1548730401 | Crystal Prater | Counselor | 5234 W Sr 63, Lebanon, OH 45036 | 2018-12-04 |
| 1922574284 | Ellen L Fink | Counselor | 5234 Sr 63, Lebanon, OH 45036 | 2018-10-15 |
| 1255832275 | Primary Care Partners of Ohio | Family Medicine | 726 E Main St Ste F205, Lebanon, OH 45036 | 2018-02-25 |
| 1548769599 | Chelsea R Perkins | Case Manager/Care Coordinator | 975 Kingsview Drive Bldg B, Lebanon, OH 45036 | 2018-02-06 |
| 1184133829 | Mary Bennett | Speech-Language Pathologist | 6760 Oh St Rt. 34, Lynchburg, OH 45036 | 2017-09-26 |
| 1699292912 | Robert Earl Offutt | Counselor | 5234 State Rt.63, Lebanon, OH 45036 | 2017-08-28 |
| 1407381528 | Kari Bump | Counselor | 320 E Silver St, Lebanon, OH 45036 | 2017-04-26 |
| 1154780435 | Ohio Department of Rehabilitation and Correction | Public Health or Welfare | State Route 63, Lebanon, OH 45036 | 2016-02-16 |
| Find all providers in zip 45036 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326664947 | Fm Oaks, LLC | Assisted Living Facility | 621 W Oak St, Lebanon, OR 97355-1788 | 2020-06-19 |
| 1427401546 | Bellwood Assisted Living LLC | Assisted Living Facility | 3190 Carthage Hwy, Lebanon, TN 37087-9564 | 2016-07-14 |
| 1720416399 | Al Lebanon Operations, LLC | Assisted Living Facility | 860 Norman Dr, Lebanon, PA 17042-7499 | 2013-10-17 |
| 1891032710 | Southern Manor Living Centers of Lebanon, LLC | Assisted Living Facility | 900 Coles Ferry Pike, Lebanon, TN 37087-5677 | 2013-01-11 |
| 1043520133 | Countryside Home, LLC | Assisted Living Facility | 24499 Park Dr, Lebanon, MO 65536-5843 | 2010-10-07 |
| 1467640631 | Alice Peck Day Health Systems | Assisted Living Facility | 121 Mascoma St, Lebanon, NH 03766-2610 | 2007-10-12 |
| 1225244940 | Bristol Care, Inc. | Assisted Living Facility | 1316 Deadra Dr, Lebanon, MO 65536-4609 | 2007-05-16 |
| 1487771275 | Century Fields | Assisted Living Facility | 181 S 5th St, Lebanon, OR 97355-2711 | 2007-03-25 |
| 1306970025 | Krn-dns Inc. | Assisted Living Facility | 31841 Highway 5, Lebanon, MO 65536-6898 | 2007-03-15 |
| 1922166115 | Open Options Inc. | Assisted Living Facility | 1073 Oregonia Rd Ste A, Lebanon, OH 45036-7532 | 2006-12-04 |
| Find all providers in LEBANON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.