Healthcare Provider Details

I. General information

NPI: 1942009634
Provider Name (Legal Business Name): HPC OHIO SENIOR LIVING 1, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2025
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 ALBON RD
MAUMEE OH
43537-9752
US

IV. Provider business mailing address

801 HUNTINGTON AVE
WARREN IN
46792-9402
US

V. Phone/Fax

Practice location:
  • Phone: 419-865-3002
  • Fax: 419-865-1283
Mailing address:
  • Phone: 260-375-2201
  • Fax: 260-375-3327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: EDWIN TYLER RICE
Title or Position: CFO
Credential:
Phone: 260-375-2201