The Commons of Providence

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

THE COMMONS OF PROVIDENCE

Practice address

5000 Providence Dr
Sandusky, OH 44870-1410

Phone

(419) 624-1171

NPI assigned

Jul 3, 2024

Organization subpart

No

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

Authorized official

Name

Matthew Wine

Title

Director of Ancillry Contracting

Phone

(513) 562-7202

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1719964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719964800000",
    "number": "1104662600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 PROVIDENCE DR",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448701410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 PROVIDENCE DR",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448701410",
            "telephone_number": "419-624-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE COMMONS OF PROVIDENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A",
        "authorized_official_last_name": "WINE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "DIRECTOR OF ANCILLRY CONTRACTING",
        "authorized_official_telephone_number": "513-562-7202"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Sandusky, OH
• Providers in Sandusky, 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 Jul 3, 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.