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EDGEWATER PLACE INC. NPI 1558690503


NPI Information

NPI: 1558690503
Provider Name: EDGEWATER PLACE, INC.

Former Legal Business Name: EDGEWATER ASSISTED LIVING LLC DBA EDGEWATER PLACE ASSISTED LI

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 36D2016478

Address:
11351 LAFAYETTE PLAIN CITY ROAD
PLAIN CITY, OH
ZIP 43064
Phone: (614) 873-9700
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EDGEWATER PLACE, INC. is an assisted living facility in Plain City, 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. EDGEWATER PLACE, INC. NPI is 1558690503. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Edgewater Assisted Living Llc Dba Edgewater Place Assisted Li.

The provider's business location address is:

11351 LAFAYETTE PLAIN CITY ROAD
PLAIN CITY, OH
ZIP 43064
Phone: (614) 873-9700
Fax: (614) 873-9770

The provider's authorized official is Sandra K Harris .
The authorized official title is Executive Director and has the following contact phone number (614) 873-9700.

The CLIA number assigned to this NPI record is 36D2016478 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/21/2009 and was last updated on 6/7/2018.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1310400000XAssisted Living Facility2546ROHIOYes

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.