Majestic Care of Cedar Village Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MAJESTIC CARE OF CEDAR VILLAGE ASSISTED LIVING LLC

Doing business as

Majestic Care of Cedar Village Assisted Living

Practice address

5467 Cedar Village Dr
Mason, OH 45040-8693

Phone

(513) 754-3100

Fax

(513) 336-3168

NPI assigned

Mar 28, 2022

Last updated

Jul 20, 2023By 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

Paul Pruitt III

Title

Ceo

Phone

(317) 288-4029

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Majestic Care of Cedar Village Assisted Living Doing business as

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689811200000",
    "number": "1124778493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5467 CEDAR VILLAGE DR",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450408693",
            "telephone_number": "513-754-3100",
            "fax_number": "513-336-3168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5467 CEDAR VILLAGE DR",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450408693",
            "telephone_number": "513-754-3100",
            "fax_number": "513-336-3168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAJESTIC CARE OF CEDAR VILLAGE ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-28",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A",
        "authorized_official_last_name": "PRUITT",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-288-4029",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE",
            "identifier": "2109R",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Majestic Care of Cedar Village Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Majestic Care of Cedar Village Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hamidreza Madani, DMD
• Courtnee Madaris-Grier
• Naga Prasuna Madireddy, M.D.
• Sabrina Marie Mahan
• Heather Marie Maier, MSN, CNP
• Majestic Care of Cedar Village LLC (Majestic Care of Cedar Village)
• Raegan E Malblanc, LPC
• John F Mallery, LISW
• Mammja LLC
• Manahan Comprehensive Wellness LLC

• Assisted Living Facility in Mason, OH
• Providers in Mason, 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 20, 2023; 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.