MEDICARE: DRAKE DEVELOPMENT, INC

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
1	310400000X	Assisted Living Facility	2306R	OH

General Provider Information

NPI Number	:	1356579676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRAKE DEVELOPMENT, INC

Provider Business Mailing Address
First Line	:	165 W GALBRAITH RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45216-1033
Country	:	US
Telephone Number	:	513-418-4371
Fax Number	:	513-418-4379

Provider Business Practice Location Address
First Line	:	165 W GALBRAITH RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45216-1033
Country	:	US
Telephone Number	:	513-418-4371
Fax Number	:	513-418-4379

Authorized Official
Title or Position	:	SENIOR VICE PRESIDENT
Name	:	DR. KAREN BANKSTON
Credential	:	R.N.; PHD
Telephone Number	:	513-418-2509

Provider Enumeration Date	:	06/25/2009
Last Update Date	:	04/13/2010

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