Provider Demographics
NPI:1669209185
Name:ASHFORD OF BEAVERCREEK LLC
Entity type:Organization
Organization Name:ASHFORD OF BEAVERCREEK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT, SENIOR LIVIN
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-552-5627
Mailing Address - Street 1:160 W MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-1189
Mailing Address - Country:US
Mailing Address - Phone:614-552-5627
Mailing Address - Fax:
Practice Address - Street 1:3865 PARK OVERLOOK DR
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-5802
Practice Address - Country:US
Practice Address - Phone:937-900-0945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility