Pristine Senior Living of Mansfield, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PRISTINE SENIOR LIVING OF MANSFIELD, LLC

Practice address

535 Lexington Ave
Mansfield, OH 44907-1502

Phone

(419) 756-7111

NPI assigned

Jul 20, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Christopher T Cook

Title

Chief Executive Officer

Phone

(317) 408-8491

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437350400000",
    "number": "1285019224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W PURDUE AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473046356",
            "telephone_number": "317-408-8491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 LEXINGTON AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071502",
            "telephone_number": "419-756-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISTINE SENIOR LIVING OF MANSFIELD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-20",
        "last_updated": "2015-07-20",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "317-408-8491",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2411929",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; 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.