Putnam Heritage Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

2417R Issued in OH

Legal business name

PUTNAM HERITAGE ASSISTED LIVING LLC

Practice address

1380 N Locust St
Ottawa, OH 45875-1163

Phone

(419) 523-5152

Fax

(419) 523-5153

NPI assigned

Feb 5, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Charles David

Title

President

Phone

(419) 350-5652

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1233792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233792000000",
    "number": "1518106038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 N LOCUST ST",
            "city": "OTTAWA",
            "state": "OH",
            "postal_code": "458751163",
            "telephone_number": "419-523-5152",
            "fax_number": "419-523-5153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 N LOCUST ST",
            "city": "OTTAWA",
            "state": "OH",
            "postal_code": "458751163",
            "telephone_number": "419-523-5152",
            "fax_number": "419-523-5153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUTNAM HERITAGE ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-05",
        "last_updated": "2009-02-05",
        "status": "A",
        "authorized_official_last_name": "DAVID",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-350-5652",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OH",
            "license": "2417R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Putnam Parkway Eyecare, LLC
• Augusta L Quinn, PCC
• Destiny Lee Ramos
• Alexandra Marie Ratliff
• Merrill Augustine Raye, D.C.

• Assisted Living Facility in Ottawa, OH
• Providers in Ottawa, 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 Feb 5, 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.

Verify at the official NPI Registry.