Provider Demographics
NPI:1326004409
Name:COMMUNITY MERCY HEALTH PARTNERS
Entity Type:Organization
Organization Name:COMMUNITY MERCY HEALTH PARTNERS
Other - Org Name:MERCY HEALTH-OAKWOOD VILLAGE SENIOR LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:JENELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZELINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-523-6634
Mailing Address - Street 1:1500 VILLA RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45503-1656
Mailing Address - Country:US
Mailing Address - Phone:937-390-9000
Mailing Address - Fax:
Practice Address - Street 1:1500 VILLA RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503
Practice Address - Country:US
Practice Address - Phone:937-390-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY MERCY HEALTH PARTNERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-26
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2058713Medicaid
OH2058713Medicaid