Provider Demographics
NPI:1013213974
Name:PRAM/MIDDLETOWN TE, LLC
Entity Type:Organization
Organization Name:PRAM/MIDDLETOWN TE, LLC
Other - Org Name:SPRING HILLS MIDDLETOWN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:HIMES
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:513-424-9999
Mailing Address - Street 1:3851 TOWNE BLVD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-5595
Mailing Address - Country:US
Mailing Address - Phone:513-424-9999
Mailing Address - Fax:513-424-9988
Practice Address - Street 1:3851 TOWNE BLVD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45005-5595
Practice Address - Country:US
Practice Address - Phone:513-424-9999
Practice Address - Fax:513-424-9988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2287R310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility