The Centrum at Willow Brook , Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

5176 Issued in OH

Legal business name

THE CENTRUM AT WILLOW BROOK , INC

Practice address

100 Willow Brook Way So.
Delaware, OH 43015-3249

Phone

(740) 369-0048

Fax

(740) 369-7034

NPI assigned

Sep 15, 2008

Organization subpart

Yes

Parent organization

WILLOW BROOK CHRISTIAN SERVICESAs reported in NPPES

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

Authorized official

Name

Mrs. Susan Kay Eleak, R.N.

Title

Centrum Manager

Phone

(740) 368-4696

Specialties & licenses 1

Addresses

Other names 1

• The Centrum Assisted Living Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Willow Brook Christian Services

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221436800000",
    "number": "1376792440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WILLOW BROOK WAY SO.",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430153249",
            "telephone_number": "740-369-0048",
            "fax_number": "740-369-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WILLOW BROOK WAY SO.",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430153249",
            "telephone_number": "740-369-0048",
            "fax_number": "740-369-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CENTRUM AT WILLOW BROOK , INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WILLOW BROOK CHRISTIAN SERVICES",
        "enumeration_date": "2008-09-15",
        "last_updated": "2008-09-15",
        "status": "A",
        "authorized_official_last_name": "ELEAK",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "CENTRUM MANAGER",
        "authorized_official_telephone_number": "740-368-4696",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OH",
            "license": "5176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Centrum Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Delaware, OH
• Providers in Delaware, OH by specialty
• Assisted Living Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.