NPIMap

Organization Active NPI

United Church Homes Inc

Doing business as Trinity Community at Fairborn

  • Assisted Living Facility
  • Fairborn, OH
National Provider Identifier
1205423407
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
UNITED CHURCH HOMES INC
Doing business as
Trinity Community at Fairborn
Practice address
789 Stoneybrook TRL
Fairborn, OH 45324-6021
Phone
(937) 878-0262
NPI assigned
Dec 22, 2020
Last updated
Jan 14, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Authorized official

Name
Richard D Dible
Title
Vice President of Financial Service
Phone
(740) 223-2022

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

789 Stoneybrook TRL
Fairborn, OH 45324-6021

Mailing address

PO Box 1806
Marion, OH 43301-1806
Phone (740) 382-4885

Other identifiers 1

IdentifierTypeStateIssuer
1523RMedicaidOH

Other names 1

  • Trinity Community at Fairborn Doing business as

National Provider Directory

National Provider Directory
Tax ID family
United Church Homes Inc Dba the Parkvue Community on Catawba Island24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1608595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610582400000",
    "number": "1205423407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1806",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433011806",
            "telephone_number": "740-382-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 STONEYBROOK TRL",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453246021",
            "telephone_number": "937-878-0262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED CHURCH HOMES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-22",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A",
        "authorized_official_last_name": "DIBLE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCIAL SERVICE",
        "authorized_official_telephone_number": "740-223-2022"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1523R",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Community at Fairborn",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairborn, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; 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.