Provider Demographics
NPI:1184786030
Name:HAMPTON WOODS NURSING CENTER, INC.
Entity type:Organization
Organization Name:HAMPTON WOODS NURSING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTALOCY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-792-7681
Mailing Address - Street 1:1525 E WESTERN RESERVE RD
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-3254
Mailing Address - Country:US
Mailing Address - Phone:330-707-1300
Mailing Address - Fax:
Practice Address - Street 1:1525 E WESTERN RESERVE RD
Practice Address - Street 2:
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-3254
Practice Address - Country:US
Practice Address - Phone:330-707-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2691583Medicaid
OH366329Medicare ID - Type UnspecifiedADMINASTAR FEDERAL