Indiana Leasing Co., LLC
Assisted Living Facility in Saint Marys, OH. Organization (NPI-2).
NPI number1326712902
StatusActive
Last updated in NPPESAug 6, 2021
Details
- NPI
- 1326712902
- Entity type
- Organization (NPI-2)
- Legal business name
- Indiana Leasing Co., LLC
- Organization subpart
- No
- Enumeration date
- Aug 6, 2021
- Certification date
- Jul 13, 2021
- Last updated
- Aug 6, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 310400000X | Assisted Living Facility | – | – | Yes |
Other names
- Grande Lake Healthcare Center (Doing Business As)
Practice location
1209 Indiana AveSaint Marys, OH 45885-1310
Phone 419-394-7611
Mailing address
4700 Ashwood Dr Ste 200Blue Ash, OH 45241-2424
Authorized official
Charles R Stoltz
Cfo
5135301613
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