Healthcare Provider Details

I. General information

NPI: 1952876328
Provider Name (Legal Business Name): CHI LIVING COMMUNITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2018
Last Update Date: 01/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 S WYNN RD
OREGON OH
43616-3530
US

IV. Provider business mailing address

5942 RENAISSANCE PL STE A
TOLEDO OH
43623-4716
US

V. Phone/Fax

Practice location:
  • Phone: 419-698-4331
  • Fax: 419-697-3027
Mailing address:
  • Phone: 567-455-0414
  • Fax:

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: WENDY DOLYK
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 567-455-0414