NPIMap

Organization Active NPI

Vancrest of Ada, LLC

  • Assisted Living Facility
  • Ada, OH
National Provider Identifier
1245698836
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
VANCREST OF ADA, LLC
Practice address
600 W North Ave
Ada, OH 45810-1041
Phone
(419) 238-0715
Fax
(419) 238-4814
NPI assigned
Feb 10, 2016
Last updated
May 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Authorized official

Name
Kyle Holliday
Title
Asst Cfo
Phone
(419) 238-0715

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X OH Primary

Addresses

Primary practice location

600 W North Ave
Ada, OH 45810-1041

Mailing address

120 W Main St Ste 200
Van Wert, OH 45891-1761
Phone (419) 238-0715

Other identifiers 1

IdentifierTypeStateIssuer
0183624MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
Vancrest of Ada2 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.

NPI Registry JSON

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

{
    "created_epoch": "1455062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779062400000",
    "number": "1245698836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W MAIN ST STE 200",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458911761",
            "telephone_number": "419-238-0715",
            "fax_number": "419-238-4814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W NORTH AVE",
            "city": "ADA",
            "state": "OH",
            "postal_code": "458101041",
            "telephone_number": "419-238-0715",
            "fax_number": "419-238-4814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANCREST OF ADA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-10",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A",
        "authorized_official_last_name": "HOLLIDAY",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "ASST CFO",
        "authorized_official_telephone_number": "419-238-0715"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0183624",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ada, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; 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.