Active NPI
Mount Vernon Elderly Services LLC
- Assisted Living Facility
- Mount Vernon, OH
National Provider Identifier
1770172736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Legal business name
- MOUNT VERNON ELDERLY SERVICES LLC
- Practice address
- 1350 Yauger Rd
Mount Vernon, OH 43050-9233 - Phone
- (740) 397-2350
- NPI assigned
- Jan 14, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Janet Marie Harris
- Title
- Ceo
- Phone
- (216) 536-4700
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | Primary |
Addresses
Primary practice location
1350 Yauger Rd
Mount Vernon, OH 43050-9233
Mailing address
1350 Yauger Rd
Mount Vernon, OH 43050-9233
Phone (740) 397-2350
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1690R | Other | OH | LICENSURE |
Other names 1
- Country Club Center II
National Provider Directory
National Provider Directory- Tax ID family
- CCRC II - Mount Vernon Nursing Home
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Skilled Nursing Facility
- Mount Vernon, OH
- NPI 1598831869
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610582400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1720656000000",
"number": "1770172736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1350 YAUGER RD",
"city": "MOUNT VERNON",
"state": "OH",
"postal_code": "430509233",
"telephone_number": "740-397-2350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 YAUGER RD",
"city": "MOUNT VERNON",
"state": "OH",
"postal_code": "430509233",
"telephone_number": "740-397-2350"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MOUNT VERNON ELDERLY SERVICES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-01-14",
"last_updated": "2024-07-11",
"certification_date": "2024-07-11",
"status": "A",
"authorized_official_last_name": "HARRIS",
"authorized_official_first_name": "JANET",
"authorized_official_middle_name": "MARIE",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "216-536-4700"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSURE",
"identifier": "1690R",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Country Club Center II",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Country Club Center II",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Mount Vernon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.