Extendicare Homes, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

EXTENDICARE HOMES, INC.

Practice address

3650 Beavercrest Dr
Lorain, OH 44053-1710

Phone

(440) 282-9171

Fax

(440) 282-7723

NPI assigned

Nov 17, 2006

Organization subpart

No

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

Authorized official

Name

Donna Jo Maassen

Title

Director of Compliance

Phone

(414) 908-8119

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Oak Hills Nursing Center Doing business as

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206835200000",
    "number": "1356415061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W MICHIGAN ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532032903",
            "telephone_number": "414-908-8119",
            "fax_number": "414-908-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 BEAVERCREST DR",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440531710",
            "telephone_number": "440-282-9171",
            "fax_number": "440-282-7723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDICARE HOMES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2008-03-30",
        "status": "A",
        "authorized_official_last_name": "MAASSEN",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "DIRECTOR OF COMPLIANCE",
        "authorized_official_telephone_number": "414-908-8119"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2347062",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oak Hills Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeremy Evenden, L.I.S.W.
• Jeanette Everard
• Lisa Everett, RN
• Lydia Everly, LPCC
• Extended Grace Home Care Services LLC
• F.E. Yuzon, M.D. Inc
• F.E.Yuzon, M.D. Inc.
• Nikita Marie Faddis
• Sheema M Fairley
• Faith and Wellness Counseling

• Skilled Nursing Facility in Lorain, OH
• Providers in Lorain, 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 Mar 30, 2008; 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.