1957 N. Lakeman Avenue Operating Company, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

1957 N. LAKEMAN AVENUE OPERATING COMPANY, LLC

Doing business as

Bellbrook Health Care Center

Practice address

1957 N Lakeman Dr
Bellbrook, OH 45305-1212

Phone

(937) 848-7800

Fax

(937) 848-5683

NPI assigned

Jul 15, 2005

Last updated

Nov 15, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Androsky Alberto Lugo, ESQ.

Title

Executive Vice Pres.

Phone

(201) 242-4006

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bellbrook Health Care Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352937600000",
    "number": "1003815762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1957 N LAKEMAN DR",
            "city": "BELLBROOK",
            "state": "OH",
            "postal_code": "453051212",
            "telephone_number": "937-848-7800",
            "fax_number": "937-848-5683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1957 N LAKEMAN DR",
            "city": "BELLBROOK",
            "state": "OH",
            "postal_code": "453051212",
            "telephone_number": "937-848-7800",
            "fax_number": "937-848-5683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1957 N. LAKEMAN AVENUE OPERATING COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-15",
        "last_updated": "2012-11-15",
        "status": "A",
        "authorized_official_last_name": "LUGO",
        "authorized_official_first_name": "ANDROSKY",
        "authorized_official_middle_name": "ALBERTO",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRES.",
        "authorized_official_telephone_number": "201-242-4006",
        "authorized_official_credential": "ESQ."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2347642",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bellbrook Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• A Voice4 U
• John Paul Accrocco, PT
• Nicholas Adrian, NP-C
• Bonita Ashe, LPCC
• Elise H Bealer, DC

• Skilled Nursing Facility in Bellbrook, OH
• Providers in Bellbrook, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.