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NPI Code Detail

MEDICARE: BLUE ASH CARE CENTER LLC

MEDICARE: BLUE ASH 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 Facility1395-NHOH

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 : 1912997057
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLUE ASH CARE CENTER LLC
Provider Business Mailing Address
First Line : 6600 N SAINT LOUIS AVE
Second Line :
City : LINCOLNWOOD
State : IL
Zip : 60712-3726
Country : US
Telephone Number : 847-677-9823
Fax Number : 847-677-9837
Provider Business Practice Location Address
First Line : 4900 COOPER RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45242-6915
Country : US
Telephone Number : 513-793-3362
Fax Number : 513-985-2844
Authorized Official
Title or Position : CEO
Name : MR. LEO FEIGENBAUM
Credential :
Telephone Number : 847-677-9823
Provider Enumeration Date : 10/27/2005
Last Update Date : 08/22/2020

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Directions to “BLUE ASH CARE CENTER LLC ” Practice Location

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