1942009634 NPI number — HPC OHIO SENIOR LIVING 1, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942009634 NPI number — HPC OHIO SENIOR LIVING 1, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HPC OHIO SENIOR LIVING 1, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942009634
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/13/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
801 HUNTINGTON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WARREN
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46792-9402
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
260-375-2201
Provider Business Mailing Address Fax Number:
260-375-3327

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2720 ALBON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MAUMEE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43537-9752
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-865-3002
Provider Business Practice Location Address Fax Number:
419-865-1283
Provider Enumeration Date:
03/13/2025

Additional Information

Authorized Official

Authorized Official Last Name:
RICE
Authorized Official First Name:
EDWIN
Authorized Official Middle Name:
TYLER
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
260-375-2201

Provider Taxonomy Codes

  • Taxonomy code: 314000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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