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NPI Code Detail

MEDICARE: KING TREE LEASING CO., LLC

MEDICARE: KING TREE LEASING CO., LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility1649NOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114918836
Entity Type Code : Organization
Provider Name (Legal Business Name) : KING TREE LEASING CO., LLC
Provider Business Mailing Address
First Line : 10123 ALLIANCE RD
Second Line :
City : BLUE ASH
State : OH
Zip : 45242-4887
Country : US
Telephone Number : 513-530-1808
Fax Number :
Provider Business Practice Location Address
First Line : 1390 KING TREE DR
Second Line :
City : DAYTON
State : OH
Zip : 45405-1401
Country : US
Telephone Number : 937-278-0723
Fax Number : 937-278-1989
Authorized Official
Title or Position : SECRETARY / TREASURER
Name : CHARLES R STOLTZ
Credential :
Telephone Number : 513-530-1808
Provider Enumeration Date : 11/02/2005
Last Update Date : 05/01/2025

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Directions to “KING TREE LEASING CO., LLC ” Practice Location

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