Friends of Good Shepherd Manor
NPI #1912110925 in Lucasville, Ohio
Provider Information
- NPI Number
- 1912110925
- Entity Type
- Organization
- Organization Name
- Friends of Good Shepherd Manor
- Primary Specialty
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- May 7, 2007
- Last Updated
- Feb 11, 2009
Practice Location
- Address
- 374 GOOD MANOR RD.
- City
- Lucasville
- State
- Ohio
- ZIP Code
- 45648-1029
- Phone
- (740) 289-2861
Authorized Official
- Name
- MS. JACKIE BRENDA BOWLING
- Title
- EXECUTIVE DIRECTOR
- Phone
- (740) 289-2861
Specialties & Taxonomy Codes
| Specialty |
|---|
| Intermediate Care Facility, Intellectual Disabilities |
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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