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General NPI Number Information
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NPI Number | 1396108973
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Entity Type | Organization
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Legal Business Name | CHI LIVING COMMUNITIES
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Dates
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Enumeration Date | 04/01/2016
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Last Update Date | 04/01/2016
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Provider Practice Location Address
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Address Line | 12469 FIVE POINT RD
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City | PERRYSBURG
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State | OH
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Zip | 43551-9615
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Country | US
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Telephone | 419-931-0050
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Fax |
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Provider Business Mailing Address
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Address Line | 12469 FIVE POINT RD
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City | PERRYSBURG
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State | OH
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Zip | 43551-9615
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT OF OPERATIONS
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Name | WENDY DOLYK
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Credential |
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Telephone | 567-455-0414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 2638A
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License Number State | OH
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