Healthcare Provider Details

I. General information

NPI: 1619078839
Provider Name (Legal Business Name): WALNUT HILLS RETIREMENT COMMUNTIES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 02/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4748 OLDE PUMP STREET
WALNUT CREEK OH
44687
US

IV. Provider business mailing address

PO BOX 127
WALNUT CREEK OH
44687-0127
US

V. Phone/Fax

Practice location:
  • Phone: 330-893-3200
  • Fax: 330-893-3382
Mailing address:
  • Phone: 330-893-3200
  • Fax: 330-893-3382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number4017
License Number StateOH

VIII. Authorized Official

Name: JEREMY KAUFFMAN
Title or Position: ADMINISTRATOR
Credential: LNHA
Phone: 330-893-3200