Provider Demographics
NPI:1518145978
Name:SOUTH II LEASING CO., LLC
Entity Type:Organization
Organization Name:SOUTH II LEASING CO., LLC
Other - Org Name:COMMONS AT GREENBRIAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. REIMB. ANALYST
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-530-1607
Mailing Address - Street 1:4700 ASHWOOD DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-2465
Mailing Address - Country:US
Mailing Address - Phone:513-489-7100
Mailing Address - Fax:
Practice Address - Street 1:8060 SOUTH AVE
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-6108
Practice Address - Country:US
Practice Address - Phone:330-758-8855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility