GRAND LAKE OPERATIONS, LLC
NPI 1720633639
Skilled Nursing Facility in Saint Marys, OH

Active since August 07, 2019
1035 HAGER STREET, SAINT MARYS, OH 45885(419) 394-3308(419) 394-3300 Get Directions Write a Review

NPPES record last updated: May 19, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 19, 2026, Jun 26, 2020, Aug 7, 2019 (3 updates tracked since 2019).

About Grand Lake Operations, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRAND LAKE OPERATIONS, LLC (NPI 1720633639) is a healthcare organization registered as a skilled nursing facility in Saint Marys, Ohio and active in the NPI registry since August 2019. The organization lists Edgar Silalahi, Cfo, as its authorized official.

NPPES Registry Identity

NPI1720633639
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameGRAND LAKE OPERATIONS, LLC
Location Address1035 HAGER STREETSaint Marys, OH 45885
Mailing Address120 W Main St Ste 200Van Wert, OH 45891-1761 · (419) 238-0715 · Fax (419) 238-4814
Fax(419) 394-3300
Organization SubpartNo
Authorized OfficialEdgar SilalahiCfo · (419) 238-0715
Enumeration DateAugust 7, 2019
Last NPPES UpdateMay 19, 20263 updates tracked since enumeration
NPPES CertifiedMay 19, 2026
NPI 1720633639 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

1035 HAGER STREET, Saint Marys, OH 45885

Other Identifiers 1

Medicaid0363613OH

Accepted Insurance

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Assisted Living Facility
1035 HAGER STREET
SAINT MARYS, OH 45885

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Grand Lake Operations, LLC's NPI number?

The NPI number for Grand Lake Operations, LLC is 1720633639. It was assigned to this organization in the NPPES registry on August 7, 2019.

Where is Grand Lake Operations, LLC located?

Grand Lake Operations, LLC is located at 1035 Hager Street, Saint Marys, OH 45885. The listed phone number is (419) 394-3308.

What is Grand Lake Operations, LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

What insurance does Grand Lake Operations, LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 1 other insurer list Grand Lake Operations, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Grand Lake Operations, LLC was last updated on May 19, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.