FRIENDS OF GOOD SHEPHERD MANOR (NPI# 1134368459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134368459 |
| Entity Type | Organization |
| Organization Name | FRIENDS OF GOOD SHEPHERD MANOR |
| Practice Address |
374 Good Manor Rd Lucasville OH 45648 |
| Mailing Address |
374 Good Manor Rd Po Box 1029 Lucasville OH 45648 |
| Practice Telephone | 7402892861 |
| Practice Fax Number | 7402894355 |
| Mailing Telephone | 7402892861 |
| Mailing Fax Number | 7402894355 |
| Enumeration Date | 2009-02-10 |
| Last Update Date | 2009-02-10 |
| Authorized Official Name | MS. JACKIE BOWLING (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7402892861 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2234344 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912110925 | Friends of Good Shepherd Manor | Intermediate Care Facility, Mentally Retarded | 374 Good Manor Rd., Lucasville, OH 45648-1029 | 2007-05-07 |
| 1275704546 | Friends of Good Shepherd Manor | Intermediate Care Facility, Mentally Retarded | 374 Good Manor Rd., Lucasville, OH 45648 | 2008-03-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | FRIENDS OF GOOD SHEPHERD MANOR HOUSING ORGANIZATION, INC. | 374 Good Manor Rd, Lucasville, OH 45648-9606 |
| Street Address |
374 GOOD MANOR RD |
| City | LUCASVILLE |
| State | OH |
| Zip Code | 45648 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962839977 | Advancing Abilities, Inc. | Intermediate Care Facility, Mentally Retarded | 374 Good Manor Rd, Lucasville, OH 45648-9606 | 2013-10-04 |
| 1740558188 | Scioto Group Home, Inc. | Intermediate Care Facility, Mentally Retarded | 374 Good Manor Rd, Lucasville, OH 45648-9606 | 2011-12-13 |
| 1568730901 | Scioto Group Home, Inc. | Intermediate Care Facility, Mentally Retarded | 374 Good Manor Rd, Lucasville, OH 45648-9606 | 2011-12-13 |
| 1538436340 | Scioto Group Home, Inc. | Intermediate Care Facility, Mentally Retarded | 374 Good Manor Rd, Lucasville, OH 45648-9606 | 2011-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558762138 | Cobra Pharmacy, LLC | Pharmacy | 37 C Lucasville-minford Road, Lucasville, OH 45648 | 2014-09-15 |
| 1366842221 | Premier Therapy & Health Centers, Inc. | Clinic/Center | 10606 U.S. 23, Lucasville, OH 45648 | 2014-08-28 |
| 1720495260 | Stephanie Jordan | Contractor | 9500 Campcreek Rd, Lucasville, OH 45648 | 2014-07-16 |
| 1851630255 | Amy D Reeder | Occupational Therapy Assistant | 10098a Big Bearcreek, Lucasville, OH 45648 | 2013-02-05 |
| 1033458567 | Christopher E Holbrook Sr. | Durable Medical Equipment & Medical Supplies | 10324 Us Rte 23, Lucasville, OH 45648 | 2013-02-04 |
| 1366735953 | Health Maintenance Partners, Inc. | Clinic/Center | 10701 Us 23 South, Lucasville, OH 45648 | 2011-05-16 |
| 1154552271 | Dianne N Bragdon | Licensed Practical Nurse | 115 Borders Road, Lucasville, OH 45648 | 2009-08-06 |
| 1366688897 | Scioto Ambulance District | Ambulance | 7106 Big Bear Creek Road, Lucasville, OH 45648 | 2009-01-06 |
| 1831311422 | Cheryl Annette Frazier | Licensed Practical Nurse | 763 Dewey Ext, Lucasville, OH 45648 | 2007-05-03 |
| 1457576522 | Christina Marie Miller | Home Health Aide | 316 Luckett Rd, Lucasville, OH 45648 | 2007-04-16 |
| Find all providers in zip 45648 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912110925 | Friends of Good Shepherd Manor | Intermediate Care Facility, Mentally Retarded | 374 Good Manor Rd., Lucasville, OH 45648-1029 | 2007-05-07 |
| 1962839977 | Advancing Abilities, Inc. | Intermediate Care Facility, Mentally Retarded | 374 Good Manor Rd, Lucasville, OH 45648-9606 | 2013-10-04 |
| 1740558188 | Scioto Group Home, Inc. | Intermediate Care Facility, Mentally Retarded | 374 Good Manor Rd, Lucasville, OH 45648-9606 | 2011-12-13 |
| 1568730901 | Scioto Group Home, Inc. | Intermediate Care Facility, Mentally Retarded | 374 Good Manor Rd, Lucasville, OH 45648-9606 | 2011-12-13 |
| 1538436340 | Scioto Group Home, Inc. | Intermediate Care Facility, Mentally Retarded | 374 Good Manor Rd, Lucasville, OH 45648-9606 | 2011-11-22 |
| 1275704546 | Friends of Good Shepherd Manor | Intermediate Care Facility, Mentally Retarded | 374 Good Manor Rd., Lucasville, OH 45648 | 2008-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164020616 | Viaquest Healthcare Central | Intermediate Care Facility, Mentally Retarded | 6873 Dave Dr, Madison, OH 44057-1105 | 2020-10-15 |
| 1366056210 | Res-care Ohio, Inc. | Intermediate Care Facility, Mentally Retarded | 410 Abbe Road, Sheffield Lake, OH 44054 | 2020-09-08 |
| 1619581568 | Res-care Ohio, Inc. | Intermediate Care Facility, Mentally Retarded | 460 Abbe Road, Sheffield Lake, OH 44054 | 2020-09-08 |
| 1548874589 | Res-care Ohio, Inc. | Intermediate Care Facility, Mentally Retarded | 448 Opportunity Way, Lagrange, OH 44050-9021 | 2020-09-08 |
| 1194339044 | Res-care Ohio, Inc. | Intermediate Care Facility, Mentally Retarded | 5230 East Lake Road, Sheffield Lake, OH 44054 | 2020-09-08 |
| 1326652496 | Res-care Ohio, Inc. | Intermediate Care Facility, Mentally Retarded | 801 Robinwood, Sheffield Lake, OH 44054 | 2020-09-04 |
| 1346854890 | Res-care Ohio, Inc. | Intermediate Care Facility, Mentally Retarded | 426 Opportunity Way, Lagrange, OH 44050-9021 | 2020-09-02 |
| 1144841438 | Wood Lane Residential Services | Intermediate Care Facility, Mentally Retarded | 355 W Main St., Portage, OH 43451-9802 | 2020-04-28 |
| 1689209009 | 333 Therapeutics Consulting LLC | Intermediate Care Facility, Mentally Retarded | 331 Toby Rd, Eaton, OH 45320-9529 | 2020-03-05 |
| 1700418258 | Jewish Family Service Association | Intermediate Care Facility, Mentally Retarded | 8132 Cedar Rd, Chesterland, OH 44026-3548 | 2020-02-12 |
| Find all providers with the same taxonomy | ||||
| City | LUCASVILLE |
| Zip Code | 45648 |
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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.