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General NPI Number Information
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NPI Number | 1528872579
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Entity Type | Organization
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Legal Business Name | LANDING OF LONG COVE, LLC
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Dates
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Enumeration Date | 02/01/2025
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Last Update Date | 02/01/2025
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Provider Practice Location Address
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Address Line | 5535 IRWIN SIMPSON RD
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City | MASON
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State | OH
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Zip | 45040-8107
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Country | US
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Telephone | 513-229-3155
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Fax |
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Provider Business Mailing Address
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Address Line | 130 SAINT MATTHEWS AVE STE 302
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City | LOUISVILLE
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State | KY
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Zip | 40207-3142
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Country | US
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Telephone | 502-777-1127
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BRYAN J CULLITON
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Credential |
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Telephone | 502-777-1127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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