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NPI Code Detail

MEDICARE: GLENDALE PLACE CARE CENTER LLC

MEDICARE: GLENDALE PLACE CARE CENTER 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 Facility2450NOH

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 : 1427081629
Entity Type Code : Organization
Provider Name (Legal Business Name) : GLENDALE PLACE CARE CENTER LLC
Provider Business Mailing Address
First Line : 779 GLENDALE MILFORD RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45215-1161
Country : US
Telephone Number : 513-771-1779
Fax Number : 513-771-4799
Provider Business Practice Location Address
First Line : 779 GLENDALE MILFORD RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45215-1161
Country : US
Telephone Number : 513-771-1779
Fax Number : 513-771-4799
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. CHASE M. KOHN
Credential :
Telephone Number : 513-771-1779
Provider Enumeration Date : 07/09/2006
Last Update Date : 09/17/2007

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Directions to “GLENDALE PLACE CARE CENTER LLC ” Practice Location

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