Provider Demographics
NPI: | 1558355487 |
---|---|
Name: | DANIEL DRAKE CENTER FOR POST-ACUTE CARE, LLC |
Entity Type: | Organization |
Organization Name: | DANIEL DRAKE CENTER FOR POST-ACUTE CARE, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | EXECUTIVE VP & CFO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | HUGH |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | HINDS |
Authorized Official - Suffix: | JR |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 513-585-8720 |
Mailing Address - Street 1: | 3200 BURNET AVENUE |
Mailing Address - Street 2: | |
Mailing Address - City: | CINCINNATI |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 45229-3019 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 513-585-8074 |
Mailing Address - Fax: | 513-585-8070 |
Practice Address - Street 1: | 151 W GALBRAITH RD |
Practice Address - Street 2: | |
Practice Address - City: | CINCINNATI |
Practice Address - State: | OH |
Practice Address - Zip Code: | 45216-1015 |
Practice Address - Country: | US |
Practice Address - Phone: | 513-418-2500 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2005-09-07 |
Last Update Date: | 2013-08-01 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
103T00000X, 207Q00000X, 207R00000X, 207RC0000X, 207RG0100X, 207RN0300X, 207RP1001X, 207Y00000X, 208100000X, 2084N0400X, 208600000X, 2086S0102X, 282N00000X, 363A00000X | ||
OH | 1409 | 282E00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 282E00000X | Hospitals | Long Term Care Hospital | Group - Multi-Specialty | |
No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
No | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | Group - Multi-Specialty |
No | 207RN0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | Group - Multi-Specialty |
No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Multi-Specialty |
No | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | Group - Multi-Specialty | |
No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
No | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
No | 2086S0102X | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | Group - Multi-Specialty |
No | 282N00000X | Hospitals | General Acute Care Hospital | Group - Multi-Specialty | |
No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
OH | 000000003166 | Other | ANTHEM HOSPITAL |
OH | 0153828 | Medicaid | |
OH | 2315202 | Medicaid | |
OH | 000000298165 | Other | ANTHEM SKILLED NURSING |
OH | 50-00175 | Other | UNITED HEALTHCARE OF OHIO |
OH | =========005 | Other | MEDICAL MUTUAL OH REHAB |
OH | =========03 | Other | OHIO BWC SKILLED |
OH | 000000298165 | Other | ANTHEM SKILLED NURSING |
OH | =========00 | Other | OHIO BWC HOSPITAL |
OH | 50-00175 | Other | UNITED HEALTHCARE OF OHIO |
OH | 2315202 | Medicaid |