Provider Demographics
NPI:1497800866
Name:CENTER RIDGE NURSING HOME, INC.
Entity Type:Organization
Organization Name:CENTER RIDGE NURSING HOME, INC.
Other - Org Name:CENTER RIDGE HEALTH CAMPUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:A
Authorized Official - Last Name:PARTYKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-387-5551
Mailing Address - Street 1:38642 CENTER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-5812
Mailing Address - Country:US
Mailing Address - Phone:440-387-5551
Mailing Address - Fax:440-327-6172
Practice Address - Street 1:38600 CENTER RIDGE RD
Practice Address - Street 2:
Practice Address - City:NORTH RIDGEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44039-2837
Practice Address - Country:US
Practice Address - Phone:440-327-1295
Practice Address - Fax:440-353-0204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
310400000X
OH4541314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0627558Medicaid
OH2566ROtherOHIO DEPARTMENT OF HEALTH
OH4541OtherOHIO DEPARTMENT OF HEALTH