Harborside of Dayton Limited Partnership

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

5324 Issued in OH

Legal business name

HARBORSIDE OF DAYTON LIMITED PARTNERSHIP

Doing business as

New Lebanon Care and Rehabilitation Center

Practice address

101 Mills PL
New Lebanon, OH 45345-1430

Phone

(937) 687-1311

Fax

(937) 687-3991

NPI assigned

Aug 22, 2006

Last updated

Oct 1, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

SUNBRIDGE HEALTHCARE CORPORATIONAs reported in NPPES

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

Addresses

Other identifiers 1

Other names 1

• New Lebanon Care and Rehabilitation Center Doing business as

Part of

Sunrise HLTH Care Corp

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254355200000",
    "number": "1699881441",
    "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": "101 MILLS PL",
            "city": "NEW LEBANON",
            "state": "OH",
            "postal_code": "453451430",
            "telephone_number": "937-687-1311",
            "fax_number": "937-687-3991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBORSIDE OF DAYTON LIMITED PARTNERSHIP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUNBRIDGE HEALTHCARE CORPORATION",
        "enumeration_date": "2006-08-22",
        "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": "5324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2083749",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Lebanon Care and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kymbir Evans
• Lora Jean Ferrar, LPT, MST
• Kate Fields
• Beverly Ann Frame
• Amanda Nicole Gengler, NP-C
• Jason Harlow
• Catrina Yvenne Hater
• Jeanie Lynn Hauser
• James F Hofmann, D.D.S.
• Hania Itawi

• Skilled Nursing Facility in New Lebanon, OH
• Providers in New Lebanon, 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 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.

Verify at the official NPI Registry.