Provider Demographics
NPI:1437130556
Name:EPISCOPAL RETIREMENT HOMES, INC.
Entity Type:Organization
Organization Name:EPISCOPAL RETIREMENT HOMES, INC.
Other - Org Name:MARJORIE P LEE RETIREMENT COMMUNITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:VEHLING
Authorized Official - Suffix:
Authorized Official - Credentials:LIC NURSIN HOME ADM
Authorized Official - Phone:513-871-2090
Mailing Address - Street 1:3550 SHAW AVENUE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208
Mailing Address - Country:US
Mailing Address - Phone:513-871-2090
Mailing Address - Fax:513-533-5096
Practice Address - Street 1:3550 SHAW AVENUE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208
Practice Address - Country:US
Practice Address - Phone:513-871-2090
Practice Address - Fax:513-533-5096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-07
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH520008314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0041672Medicaid
OH365802Medicare ID - Type Unspecified