=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497982995
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WHISPERING PINES VILAGE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/11/2009
-----------------------------------------------------
Last Update Date | 06/11/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 937 E PARK AVE
-----------------------------------------------------
City | COLUMBIANA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44408-1451
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-482-9400
-----------------------------------------------------
Fax | 330-428-3226
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 937 E PARK AVE
-----------------------------------------------------
City | COLUMBIANA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44408-1451
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax | 330-482-3226
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | ROBERT SCHWARTZ
-----------------------------------------------------
Credential | CEO
-----------------------------------------------------
Telephone | 330-428-9400
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 310400000X
-----------------------------------------------------
Taxonomy Name | Assisted Living Facility
-----------------------------------------------------
License Number | 6103
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------