NPIMap

Organization Active NPI

Filling Memorial Home Egly

  • Intellectual Disabilities Intermediate Care Facility
  • West Unity, OH
National Provider Identifier
1053460485
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
24432 Issued in OH
Legal business name
FILLING MEMORIAL HOME EGLY
Practice address
101 Egly Drive
West Unity, OH 43570-9533
Phone
(419) 924-2806
Fax
(419) 924-2806
NPI assigned
Jan 8, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Carol Cecilia Schroeder, MBOL
Title
Chief Financial Officer
Phone
(419) 592-6451

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 24432 OH Primary

Addresses

Primary practice location

101 Egly Drive
West Unity, OH 43570-9533

Mailing address

N 160 SB 108
Napoleon, OH 43545-9363
Phone (419) 592-6451

Other identifiers 2

IdentifierTypeStateIssuer
0361439MedicaidOH
9222OtherODH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053460485. Details of each certification follow.

  • CCN 36G262 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 36G262

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
EGLY DRIVE HOME
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Jan 21, 1987
Last certification
Jul 29, 2025
Beds
8
Ownership / control type
Private (non-profit)
Most recent change of ownership
Jan 1, 2003
Facility address
101 Egly Drive
West Unity, OH 43570

National Provider Directory

National Provider Directory
Tax ID family
Filling Memorial Home Egly5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

N160 State Route 108
Napoleon, OH 43545
Phone (419) 592-6451

101 Egly Dr
West Unity, OH 43570
Phone (419) 924-2806

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053460485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N 160 SB 108",
            "city": "NAPOLEON",
            "state": "OH",
            "postal_code": "435459363",
            "telephone_number": "419-592-6451",
            "fax_number": "419-599-5178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 EGLY DRIVE",
            "city": "WEST UNITY",
            "state": "OH",
            "postal_code": "435709533",
            "telephone_number": "419-924-2806",
            "fax_number": "419-924-2806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FILLING MEMORIAL HOME EGLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHROEDER",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "CECILIA",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "419-592-6451",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MBOL"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "OH",
            "license": "24432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0361439",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ODH",
            "identifier": "9222",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Unity, OH

Sources for this page

Verify at the official NPI Registry.