Diversicare of Mansfield, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

DIVERSICARE OF MANSFIELD, LLC

Doing business as

Ontario Pointe

Practice address

2124 Park Ave W
Ontario, OH 44906-3807

Phone

(419) 529-6447

Fax

(419) 529-2108

NPI assigned

Jul 12, 2014

Last updated

Jul 12, 2014By the provider in NPPES

Organization subpart

Yes

Parent organization

DIVERSICARE LEASING COMPANY II, LLCAs reported in NPPES

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

Authorized official

Name

Kelly J Gill

Title

President and Ceo

Phone

(615) 771-7575

Specialties & licenses 1

Addresses

Other names 1

• Ontario Pointe Doing business as

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

{
    "created_epoch": "1405123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405123200000",
    "number": "1073920948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 PARK AVE W",
            "city": "ONTARIO",
            "state": "OH",
            "postal_code": "449063807",
            "telephone_number": "419-529-6447",
            "fax_number": "419-529-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 PARK AVE W",
            "city": "ONTARIO",
            "state": "OH",
            "postal_code": "449063807",
            "telephone_number": "419-529-6447",
            "fax_number": "419-529-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSICARE OF MANSFIELD, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIVERSICARE LEASING COMPANY II, LLC",
        "enumeration_date": "2014-07-12",
        "last_updated": "2014-07-12",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "615-771-7575"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ontario Pointe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matthew W Delay, C.PED.
• Barbara Delong-Lieb
• Timothy J Denis, R.PH.
• Peter Dering
• Discount Drug Mart Inc (Discount Drug Mart)
• Jennifer A Donato
• Cynthia A Dorsey, MD
• Anne Elizabeth Doup, MSN, APRN, NP-C
• Emily Dowdell, MOT, OTR/L
• Kayla M Durbin, PT, DPT

• Skilled Nursing Facility in Ontario, OH
• Providers in Ontario, 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 Jul 12, 2014; 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.