Organization · Type 2 NPI
Friends of Good Shepherd Manor
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Lucasville, OH
Practice location
374 Good Manor Rd.
Lucasville, OH 45648-1029
Fax (740) 289-3916
Mailing address
PO Box 1029
Lucasville, OH 45648-1029
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | 6610055 (OH) |
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | 6610153 (OH) |
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | 6610306 (OH) |
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | 6600173 (OH) |
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
Another provider at this address
About NPI 1912110925
Friends of Good Shepherd Manor's National Provider Identifier is 1912110925, issued on May 7, 2007. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Lucasville, OH. The record was last updated on Feb 11, 2009.