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Friends Of Good Shepherd Manor
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Lucasville, Ohio
NPI 1912110925

Friends Of Good Shepherd Manor is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Lucasville, OH. Friends Of Good Shepherd Manor practices in Lucasville, OH. The NPI Number for Friends Of Good Shepherd Manor is 1912110925 and holds a License No. 6610055 (Ohio).

The current practice location address for Friends Of Good Shepherd Manor is 374 Good Manor Rd., Lucasville, OH and can be reached out via phone at 740-289-2861 and via fax at 740-289-3916.

Location: 374 Good Manor Rd., Lucasville, OH, 45648-1029
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1912110925
Provider Name
Friends Of Good Shepherd Manor
Credential
Provider Entity Type
Organization
Address
374 Good Manor Rd., Lucasville, OH, 45648-1029
Phone Number
740-289-2861
Fax Number
740-289-3916
Provider Enumeration Date
05/07/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0830364 05 OH
institution
Provider Business Practice Location Address Details
Address
374 Good Manor Rd.
City
Lucasville
State
Ohio
Zip
45648-1029
Phone Number
740-289-2861
Fax Number
740-289-3916
person
Provider Business Mailing Address Details
Address
374 Good Manor Rd.
City
Lucasville
State
Ohio
Zip
45648-1029
Phone Number
740-289-2861
Fax Number
740-289-3916
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
6610153 (Ohio)
Definition
(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.
person
Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
6610055 (Ohio)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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