Healthcare Provider Details

I. General information

NPI: 1376073627
Provider Name (Legal Business Name): OHIO LIVING QUAKER HEIGHTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2017
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 HIGH ST
WAYNESVILLE OH
45068-9784
US

IV. Provider business mailing address

9200 WORTHINGTON RD STE 300
WESTERVILLE OH
43082-7240
US

V. Phone/Fax

Practice location:
  • Phone: 513-897-6050
  • Fax:
Mailing address:
  • Phone: 614-888-7800
  • Fax: 614-888-6864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number6347
License Number StateOH

VIII. Authorized Official

Name: ROBERT B STILLMAN
Title or Position: CFO
Credential:
Phone: 614-888-7800