Als Bowling Green Operating, Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

ALS BOWLING GREEN OPERATING, INC

Doing business as

Heritage Corner

Practice address

1069 Klotz Rd
Bowling Green, OH 43402-4820

Phone

(419) 353-3759

Fax

(419) 728-0100

NPI assigned

Apr 17, 2024

Last updated

Nov 7, 2024By 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

Bryan Casey

Title

Partner

Phone

(740) 415-1138

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Heritage Corner Doing business as

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

{
    "created_epoch": "1713312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730937600000",
    "number": "1063266898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 PUTNAM ST STE 110",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457502952",
            "telephone_number": "740-415-1138",
            "fax_number": "201-661-2846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1069 KLOTZ RD",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434024820",
            "telephone_number": "419-353-3759",
            "fax_number": "419-728-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALS BOWLING GREEN OPERATING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-17",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A",
        "authorized_official_last_name": "CASEY",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "740-415-1138"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0069712",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RCF LICNESE",
            "identifier": "2247R",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Corner",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heritage Corner",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Bowling Green, OH
• Providers in Bowling Green, OH by specialty
• Assisted Living Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.