Active NPI
Harborside Sylvania, LLC
Doing business as Sylvania Care and Rehabilitation Center
- Skilled Nursing Facility
- Sylvania, OH
National Provider Identifier
1356458996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 5472
- Legal business name
- HARBORSIDE SYLVANIA, LLC
- Doing business as
- Sylvania Care and Rehabilitation Center
- Practice address
- 5757 Whiteford Rd
Sylvania, OH 43560-1632 - Phone
- (419) 882-1875
- Fax
- (419) 885-1272
- NPI assigned
- Aug 23, 2006
- Organization subpart
- Yes
- Parent organization
- SUNBRIDGE HEALTHCARE CORPORATION
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- William A. Mathies
- Title
- President Director
- Phone
- (505) 821-3355
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 5472 | OH | Primary |
Addresses
Primary practice location
5757 Whiteford Rd
Sylvania, OH 43560-1632
Mailing address
101 Sun Ave NE
Compliance Department
Albuquerque, NM 87109-4373
Phone (505) 468-5604
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2612926 | Medicaid | OH |
Other names 1
- Sylvania Care and Rehabilitation Center
National Provider Directory
National Provider Directory- Part of
- Terrace Hghts Nursing H
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Cottage of the Shoals
- Skilled Nursing Facility
- Tuscumbia, AL
- NPI 1285685362
Member Of
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1254355200000",
"number": "1356458996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 SUN AVE NE",
"address_2": "COMPLIANCE DEPARTMENT",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871094373",
"telephone_number": "505-468-5604",
"fax_number": "505-468-4681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5757 WHITEFORD RD",
"city": "SYLVANIA",
"state": "OH",
"postal_code": "435601632",
"telephone_number": "419-882-1875",
"fax_number": "419-885-1272"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HARBORSIDE SYLVANIA, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SUNBRIDGE HEALTHCARE CORPORATION",
"enumeration_date": "2006-08-23",
"last_updated": "2009-10-01",
"status": "A",
"authorized_official_last_name": "MATHIES",
"authorized_official_first_name": "WILLIAM",
"authorized_official_middle_name": "A.",
"authorized_official_title_or_position": "PRESIDENT DIRECTOR",
"authorized_official_telephone_number": "505-821-3355"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "OH",
"license": "5472",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2612926",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Sylvania Care and Rehabilitation Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Sylvania, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.