Provider Demographics
NPI:1982641221
Name:CHS - SPRINGDALE, INC
Entity Type:Organization
Organization Name:CHS - SPRINGDALE, INC
Other - Org Name:THE HOME AT TAYLOR'S POINTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:513-682-2700
Mailing Address - Street 1:3564 SPRINGDALE RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45251-1331
Mailing Address - Country:US
Mailing Address - Phone:513-741-4888
Mailing Address - Fax:513-741-4890
Practice Address - Street 1:8200 BECKETT PARK DR
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-8955
Practice Address - Country:US
Practice Address - Phone:513-682-2700
Practice Address - Fax:513-682-2709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2454N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2691574Medicaid
OH36-6332Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER