Provider Demographics
NPI: | 1710162607 |
---|---|
Name: | AL LIMA OPERATIONS, LLC |
Entity type: | Organization |
Organization Name: | AL LIMA OPERATIONS, LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | W. |
Authorized Official - Middle Name: | PATRICK |
Authorized Official - Last Name: | MULLOY |
Authorized Official - Suffix: | II |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 502-753-6001 |
Mailing Address - Street 1: | 9510 ORMSBY STATION RD |
Mailing Address - Street 2: | |
Mailing Address - City: | LOUISVILLE |
Mailing Address - State: | KY |
Mailing Address - Zip Code: | 40223-4081 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 502-753-6000 |
Mailing Address - Fax: | 502-753-6104 |
Practice Address - Street 1: | 2075 N EASTOWN RD |
Practice Address - Street 2: | |
Practice Address - City: | LIMA |
Practice Address - State: | OH |
Practice Address - Zip Code: | 45807-2091 |
Practice Address - Country: | US |
Practice Address - Phone: | 419-331-2442 |
Practice Address - Fax: | 419-331-9267 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-01-09 |
Last Update Date: | 2008-01-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
OH | 2206R | 310400000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility |