Provider Demographics
NPI:1174021463
Name:GA HC REIT II SEASONS TRS SUB, LLC
Entity Type:Organization
Organization Name:GA HC REIT II SEASONS TRS SUB, LLC
Other - Org Name:THE COURTYARD AT SEASONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GATENIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-547-2633
Mailing Address - Street 1:7100 DEARWESTER DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-6115
Mailing Address - Country:US
Mailing Address - Phone:513-984-7275
Mailing Address - Fax:513-985-8329
Practice Address - Street 1:7100 DEARWESTER DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-6115
Practice Address - Country:US
Practice Address - Phone:513-984-7275
Practice Address - Fax:513-985-8329
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GA HC REIT II SEASONS TRS SUB, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-01
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1888R310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0100325Medicaid