Basic Information
Provider Information
NPI: 1518466580
EntityType: 2
ReplacementNPI:  
OrganizationName: CONTINENTAL II LEASING CO., LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
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Credential:  
OtherOrganizationName: SALEM EAST HEALTHCARE CENTER
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: 4700 ASHWOOD DR SUITE 200
Address2:  
City: CINCINNATI
State: OH
PostalCode: 45241
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 230 CONTINENTAL DRIVE
Address2:  
City: SALEM
State: OH
PostalCode: 44460
CountryCode: US
TelephoneNumber: 3303379503
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/06/2018
LastUpdateDate: 02/06/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: STOLTZ
AuthorizedOfficialFirstName: CHARLES
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 5135301613
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
314000000X  Y Nursing & Custodial Care FacilitiesSkilled Nursing Facility 

No ID Information.


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