Provider Demographics
NPI:1467260182
Name:CHARDON WOODS OF JOURNEY LLC
Entity type:Organization
Organization Name:CHARDON WOODS OF JOURNEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCGUINNESS
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:463-278-0868
Mailing Address - Street 1:949 CONNER ST FL 2
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-2622
Mailing Address - Country:US
Mailing Address - Phone:463-278-0868
Mailing Address - Fax:
Practice Address - Street 1:12340 BASS LAKE RD
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-8327
Practice Address - Country:US
Practice Address - Phone:440-285-4040
Practice Address - Fax:440-285-7743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility