Provider Demographics
NPI:1679554703
Name:THE DEUPREE RETIREMENT COMMUNITY
Entity Type:Organization
Organization Name:THE DEUPREE RETIREMENT COMMUNITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:AILEEN
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:513-272-0600
Mailing Address - Street 1:4001 ROSSLYN DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209-1111
Mailing Address - Country:US
Mailing Address - Phone:513-272-0600
Mailing Address - Fax:513-272-1730
Practice Address - Street 1:4001 ROSSLYN DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-1111
Practice Address - Country:US
Practice Address - Phone:513-272-0600
Practice Address - Fax:513-272-1730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH520038314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0047943Medicaid
OH365044Medicare ID - Type Unspecified