Oak Haven Residential Care Center LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

OAK HAVEN RESIDENTIAL CARE CENTER LLC

Doing business as

Serenity Living Center

Practice address

10170 Road 5H
Ottawa, OH 45875-9715

Phone

(419) 523-3005

Fax

(419) 523-0070

NPI assigned

Dec 8, 2020

Last updated

Dec 8, 2020By 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

Sherry Webb, LPNNPI 1528463171

Title

Administrator

Phone

(419) 615-3357

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Serenity Living Center Doing business as

Electronic endpoints 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Oak Haven Residential Care Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Oak Haven Residential Care LLC

  • Assisted Living Facility
  • Cloverdale, OH
  • NPI 1780280560
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sherry Webb

  • Nursing Home Administrator
  • Cloverdale, OH
  • NPI 1528463171
  NPD Authorized official

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

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607385600000",
    "number": "1134725914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 280",
            "city": "OTTAWA",
            "state": "OH",
            "postal_code": "458750280",
            "telephone_number": "419-523-3005",
            "fax_number": "419-523-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10170 ROAD 5H",
            "city": "OTTAWA",
            "state": "OH",
            "postal_code": "458759715",
            "telephone_number": "419-523-3005",
            "fax_number": "419-523-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK HAVEN RESIDENTIAL CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-08",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A",
        "authorized_official_last_name": "WEBB",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "419-615-3357",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0231285",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swebb@oakhavenrc.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "10170 Road 5H",
            "city": "Ottawa",
            "state": "OH",
            "country_code": "US",
            "postal_code": "458759715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Serenity Living Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Ottawa, OH
• Providers in Ottawa, 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 Dec 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.