Provider Demographics
NPI:1760645485
Name:WALNUT HILLS RETIREMENT COMMUNITIES INC
Entity Type:Organization
Organization Name:WALNUT HILLS RETIREMENT COMMUNITIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-893-3200
Mailing Address - Street 1:PO BOX 127
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:OH
Mailing Address - Zip Code:44687-0127
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4748 OLDE PUMP STREET
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:OH
Practice Address - Zip Code:44687
Practice Address - Country:US
Practice Address - Phone:330-893-3200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1607R310400000X
OH4017314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2900678Medicaid
OH366268Medicare PIN