Provider Demographics
NPI:1801387568
Name:SEMMA ENTERPRISES, INC
Entity Type:Organization
Organization Name:SEMMA ENTERPRISES, INC
Other - Org Name:DBA HAWTHORN GLEN NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUMBERT
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:937-293-7703
Mailing Address - Street 1:5414 HANKINS RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-9782
Mailing Address - Country:US
Mailing Address - Phone:513-863-7775
Mailing Address - Fax:513-863-0684
Practice Address - Street 1:5414 HANKINS RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-9782
Practice Address - Country:US
Practice Address - Phone:513-863-7775
Practice Address - Fax:513-863-0684
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEMMA ENTERPRISES, INC. DBA HAWTHORN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5053310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0830506Medicaid