Provider Demographics
NPI:1619213022
Name:ST. CLARE COMMONS
Entity Type:Organization
Organization Name:ST. CLARE COMMONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:THOMPSON
Authorized Official - Last Name:LITTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-931-0050
Mailing Address - Street 1:12469 FIVE POINT ROAD
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-9615
Mailing Address - Country:US
Mailing Address - Phone:419-931-0050
Mailing Address - Fax:419-931-0052
Practice Address - Street 1:12469 FIVE POINT ROAD
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-9615
Practice Address - Country:US
Practice Address - Phone:419-931-0050
Practice Address - Fax:419-931-0052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-13
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility