Basic Information
| Provider Information | |||||||||
| NPI: | 1548804883 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | OLMSTED ASSISTED LIVING CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26376 JOHN RD | ||||||||
| Address2: | |||||||||
| City: | OLMSTED TWP | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441381277 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 26376 JOHN RD | ||||||||
| Address2: | |||||||||
| City: | OLMSTED TWP | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441381277 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402357100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/30/2019 | ||||||||
| LastUpdateDate: | 10/30/2019 | ||||||||
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| AuthorizedOfficialLastName: | CARDONE | ||||||||
| AuthorizedOfficialFirstName: | SUZANNE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CONTROLLER | ||||||||
| AuthorizedOfficialTelephone: | 4402357100 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | ELIZA JENNINGS INC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 310400000X | Y | Nursing & Custodial Care Facilities | Assisted Living Facility |
No ID Information.