Country Club Retirement Center Llc

LBN: Country Club Retirement Center Llc
Country Club Retirement Center Llc is an health care organization with primary practice located at 925 E 26Th St , Ashtabula OH 44004-5061. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Assisted Living Facility, Nursing & Custodial Care Facilities / Skilled Nursing Facility. Nursing & Custodial Care Facilities / Skilled Nursing Facility is the primary health care specialty. Country Club Retirement Center Llc can be contacted via phone (440) 992-0022, or through Harris, Janet via phone (330) 239-4474.

Contact Information

Primary practice address
925 E 26Th St Ashtabula OH 44004-5061
Phone: (440) 992-0022
Fax: (440) 992-7423
Website:
Map and Directions
Authorized official contact:
Name: Harris, Janet CPA
Phone: (330) 239-4474

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X 4561 Ohio
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 3469 Ohio

Profile Details

NPI number 1144372137
LBN Legal business name Country Club Retirement Center Llc
DBA Doing business as
Authorized official Harris, Janet CPA
Entity Organization
Organization subpart 1 No
Enumeration date Jan 18th, 2007
Last updated Apr 12th, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144372137 NPPES
Ohio Other 000000157279 ANTHEM
Ohio MEDICAID 0571322 ANTHEM

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