Provider Demographics
NPI:1306031844
Name:KARRINGTON OF ENGLEWOOD LTD
Entity Type:Organization
Organization Name:KARRINGTON OF ENGLEWOOD LTD
Other - Org Name:SUNRISE OF ENGLEWOOD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:WICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-836-9617
Mailing Address - Street 1:95 WEST WENGER ROAD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45322
Mailing Address - Country:US
Mailing Address - Phone:937-836-9617
Mailing Address - Fax:937-836-9616
Practice Address - Street 1:95 W WENGER RD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45322-2723
Practice Address - Country:US
Practice Address - Phone:937-836-9617
Practice Address - Fax:937-836-9616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility