Provider Demographics
NPI:1649578881
Name:ASSISTED LIVING MINISTRY SERVICES
Entity Type:Organization
Organization Name:ASSISTED LIVING MINISTRY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAUGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-206-0700
Mailing Address - Street 1:650 SAINT CLAIR AVE
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-3053
Mailing Address - Country:US
Mailing Address - Phone:330-385-0700
Mailing Address - Fax:
Practice Address - Street 1:650 SAINT CLAIR AVE
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-3053
Practice Address - Country:US
Practice Address - Phone:330-385-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-12
Last Update Date:2011-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
310400000X
OH2570R314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility