EC OPCO XENIA LLC NPI 1104325331

NPI Information

NPI: 1104325331
Provider Name: EC OPCO XENIA, LLC
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 36D1062297

Address:
60 PACELINE CIR
XENIA, OH
ZIP 45385
Phone: (937) 372-1530
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EC OPCO XENIA, LLC is an assisted living facility in Xenia, OH. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. EC OPCO XENIA, LLC NPI is 1104325331. The provider is registered as an organization entity type.

The provider's business location address is:

60 PACELINE CIR
XENIA, OH
ZIP 45385-281
Phone: (937) 372-1530

The provider's authorized official is Amy W. Fleming .
The authorized official title is Controller and has the following contact phone number (971) 337-3922.

The CLIA number assigned to this NPI record is 36D1062297 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/2/2018 and was last updated on 3/12/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	310400000X	Assisted Living Facility				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1902125198	MEDICAID	OHIO
2	1104138502	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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