BEREA LAKE TOWERS INC. NPI 1225160096

NPI Information

NPI: 1225160096
Provider Name: BEREA LAKE TOWERS, INC.

Doing Business As: BEREA LAKE TOWERS RETIREMENT COMMUNITY

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

Address:
4 BEREA COMMONS
BEREA, OH
ZIP 44017
Phone: (440) 243-9050
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BEREA LAKE TOWERS, INC. is an assisted living facility in Berea, 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. BEREA LAKE TOWERS, INC. NPI is 1225160096. The provider is registered as an organization entity type.
The provider Is Doing Business As Berea Lake Towers Retirement Community.

The provider's business location address is:

4 BEREA COMMONS
BEREA, OH
ZIP 44017-524
Phone: (440) 243-9050
Fax: (440) 891-0196

The provider's authorized official is Michael Robert Coury .
The authorized official title is Ceo and has the following contact phone number (440) 243-5668.

The CLIA number assigned to this NPI record is 36D1041772 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/9/2007 and was last updated on 8/22/2020.

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		6206	OHIO	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	2707913	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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