Ec Opco Xenia, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

EC OPCO XENIA, LLC

Practice address

60 Paceline Cir
Xenia, OH 45385-1281

Phone

(937) 372-1530

NPI assigned

Feb 2, 2018

Organization subpart

No

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

Authorized official

Name

Amy W. Fleming

Title

Controller

Phone

(971) 337-3922

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1517529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552348800000",
    "number": "1104325331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5885 MEADOWS RD STE 500",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358646",
            "telephone_number": "971-254-1368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 PACELINE CIR",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453851281",
            "telephone_number": "937-372-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EC OPCO XENIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-02",
        "last_updated": "2019-03-12",
        "status": "A",
        "authorized_official_last_name": "FLEMING",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "971-337-3922"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902125198",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104138502",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenton Durham
• Angela Durst
• Bethany Dykman
• Elizabeth Frances Earehart
• Anissa Earl
• Jamie Kira Lee Eckles
• Victoria C. Ederer, BSW, LSW
• Simone Edgell
• Ashley Edgerly
• Kevin Keith Edwards

• Assisted Living Facility in Xenia, OH
• Providers in Xenia, 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 Mar 12, 2019; 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.