NPIMap

Organization Active NPI

Lakewood Senior Campus, LLC

  • Assisted Living Facility
  • Lakewood, OH
National Provider Identifier
1255188124
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
LAKEWOOD SENIOR CAMPUS, LLC
Practice address
13900 Detroit Ave
Lakewood, OH 44107-4624
Phone
(216) 228-7650
Fax
(216) 228-7655
NPI assigned
Apr 30, 2024
Organization subpart
Yes
Parent organization
LAKEWOOD SENIOR CAMPUS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Authorized official

Name
John T O'Neill
Title
President
Phone
(400) 387-5555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

13900 Detroit Ave
Lakewood, OH 44107-4624

Mailing address

38642 Center Ridge Rd
North Ridgeville, OH 44039-5812
Phone (440) 387-5500

Other identifiers 1

IdentifierTypeStateIssuer
2887005MedicaidOH

Other names 1

  • O'Neill Healthcare Lakewood Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lakewood Senior Health Campus3 organizations share this tax ID, including this one
Part of
Lakewood Senior Health Campus

Other organizations with this tax ID 2

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1714435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1255188124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38642 CENTER RIDGE RD",
            "city": "NORTH RIDGEVILLE",
            "state": "OH",
            "postal_code": "440395812",
            "telephone_number": "440-387-5500",
            "fax_number": "440-327-6172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13900 DETROIT AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441074624",
            "telephone_number": "216-228-7650",
            "fax_number": "216-228-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD SENIOR CAMPUS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKEWOOD SENIOR CAMPUS, LLC",
        "enumeration_date": "2024-04-30",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "O'NEILL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "400-387-5555"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2887005",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "O'Neill Healthcare Lakewood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakewood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.