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GENTLEBROOK NPI 1548514896


NPI Information

NPI: 1548514896
Provider Name: GENTLEBROOK

Doing Business As: LAFAYETTE MEADOWS FAMILY HOME

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization

CLIA Number: 36D0333141

Address:
21632 PICKWICK ST
BOX 30
WEST LAFAYETTE, OH
ZIP 43845
Phone: (740) 545-6366
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GENTLEBROOK is an intermediate care facility mentally retarded in West Lafayette, OH. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. GENTLEBROOK NPI is 1548514896. The provider is registered as an organization entity type.
The provider Is Doing Business As Lafayette Meadows Family Home.

The provider's business location address is:

21632 PICKWICK ST
BOX 30
WEST LAFAYETTE, OH
ZIP 43845-511
Phone: (740) 545-6366

The provider's authorized official is Michael Dean Sleutz .
The authorized official title is Chief Operating Officer and has the following contact phone number (330) 877-7700.

The CLIA number assigned to this NPI record is 36D0333141 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/7/2012 and was last updated on 11/7/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1315P00000XIntermediate Care Facility, Intellectual DisabilitiesYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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