NPIMap

Organization Active NPI

Shepherd of the Valley Lutheran Retirement Services, Inc.

  • Assisted Living Facility
  • Poland, OH
National Provider Identifier
1629419239
Registry record updated Jul 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
5184 Issued in OH
Legal business name
SHEPHERD OF THE VALLEY LUTHERAN RETIREMENT SERVICES, INC.
Practice address
301 W Western Reserve Rd
Poland, OH 44514-3527
Phone
(330) 726-7110
Fax
(330) 726-2517
NPI assigned
Jul 11, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2013

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

Authorized official

Name
Victoria Brown, C.F.O.
Title
Associate Director/C.F.O.
Phone
(330) 530-4038

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 5184 OH Primary

Addresses

Primary practice location

301 W Western Reserve Rd
Poland, OH 44514-3527

Mailing address

5525 Silica Rd
Austintown, OH 44515-1002
Phone (330) 530-4038

Other identifiers 1

IdentifierTypeStateIssuer
0054967MedicaidOH

Other names 1

  • Shepherd of the Valley Poland Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Shepherd of the Valley Lutheran Retirement Services Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5525 Silica Rd
Youngstown, OH 44515
Phone (330) 530-4038

NPI Registry JSON

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

{
    "created_epoch": "1373500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373500800000",
    "number": "1629419239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 SILICA RD",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445151002",
            "telephone_number": "330-530-4038",
            "fax_number": "330-530-4039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W WESTERN RESERVE RD",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143527",
            "telephone_number": "330-726-7110",
            "fax_number": "330-726-2517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEPHERD OF THE VALLEY LUTHERAN RETIREMENT SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-11",
        "last_updated": "2013-07-11",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "ASSOCIATE DIRECTOR/C.F.O.",
        "authorized_official_telephone_number": "330-530-4038",
        "authorized_official_credential": "C.F.O."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OH",
            "license": "5184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0054967",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shepherd of the Valley Poland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Poland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2013; 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.