Provider Demographics
NPI:1235537697
Name:NRFHC-LANCASTER II OPS, LLC
Entity type:Organization
Organization Name:NRFHC-LANCASTER II OPS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VELLIQUETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-653-1423
Mailing Address - Street 1:2750 W FAIR AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-9500
Mailing Address - Country:US
Mailing Address - Phone:740-653-1423
Mailing Address - Fax:740-653-1423
Practice Address - Street 1:2750 W FAIR AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-9500
Practice Address - Country:US
Practice Address - Phone:740-653-1423
Practice Address - Fax:740-653-1423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2635R310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility