Provider Demographics
NPI:1497769137
Name:HCF OF BURTON'S RIDGE, INC.
Entity Type:Organization
Organization Name:HCF OF BURTON'S RIDGE, INC.
Other - Org Name:BURTON'S RIDGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR - CORPORATE COMPLIANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STECHSCHULTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-999-2010
Mailing Address - Street 1:2651 FORT AMANDA RD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-3730
Mailing Address - Country:US
Mailing Address - Phone:419-228-8412
Mailing Address - Fax:419-228-8612
Practice Address - Street 1:2651 FORT AMANDA RD
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-3730
Practice Address - Country:US
Practice Address - Phone:419-228-8412
Practice Address - Fax:419-228-8612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2185R310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility