Provider Demographics
NPI:1003804790
Name:TERRACE VIEW GARDENS
Entity Type:Organization
Organization Name:TERRACE VIEW GARDENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:LSW, LNHA
Authorized Official - Phone:513-481-2201
Mailing Address - Street 1:3904 N BEND RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-4855
Mailing Address - Country:US
Mailing Address - Phone:513-481-2201
Mailing Address - Fax:513-481-5240
Practice Address - Street 1:3904 N BEND RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-4855
Practice Address - Country:US
Practice Address - Phone:513-481-2201
Practice Address - Fax:513-481-5240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6259313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2339384Medicaid
OH366153Medicare ID - Type Unspecified