Healthcare Provider Details

I. General information

NPI: 1780826024
Provider Name (Legal Business Name): ASSISTED LIVING SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2009
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 PROSPECT ST
WELLINGTON OH
44090-1296
US

IV. Provider business mailing address

3905 OBERLIN AVE.
LORAIN OH
44053
US

V. Phone/Fax

Practice location:
  • Phone: 440-647-2414
  • Fax: 440-647-1624
Mailing address:
  • Phone: 440-647-2414
  • Fax: 440-647-1624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number5694
License Number StateOH

VIII. Authorized Official

Name: BRANDON MALANOWSKI
Title or Position: CFO
Credential:
Phone: 440-989-5265