Provider Demographics
NPI:1326204140
Name:BCC WASHINGTON TOWNSHIP OPERATIONS, LLC
Entity Type:Organization
Organization Name:BCC WASHINGTON TOWNSHIP OPERATIONS, LLC
Other - Org Name:ELMCROFT OF WASHINGTON TOWNSHIP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:MULLOY
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:502-753-6000
Mailing Address - Street 1:9510 ORMSBY STATION RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-4081
Mailing Address - Country:US
Mailing Address - Phone:502-753-6000
Mailing Address - Fax:502-753-6100
Practice Address - Street 1:8630 WASHINGTON CHURCH RD
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-3795
Practice Address - Country:US
Practice Address - Phone:937-291-3211
Practice Address - Fax:937-291-1608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2260R310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility