Vancrest of Payne, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

VANCREST OF PAYNE, LLC

Practice address

650 N Main St
Payne, OH 45880-9026

Phone

(419) 263-0191

Fax

(419) 263-0193

NPI assigned

Oct 17, 2013

Last updated

May 14, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kyle Holliday

Title

Asst Cfo

Phone

(419) 238-0715

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Vancrest of Payne2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Vancrest of Payne, LLC

  • Skilled Nursing Facility
  • Payne, OH
  • NPI 1609363241
  NPD tax ID

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

{
    "created_epoch": "1381968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778716800000",
    "number": "1790113330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W MAIN ST STE 200",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458911761",
            "telephone_number": "419-238-0715",
            "fax_number": "419-238-4814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 N MAIN ST",
            "city": "PAYNE",
            "state": "OH",
            "postal_code": "458809026",
            "telephone_number": "419-263-0191",
            "fax_number": "419-263-0193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANCREST OF PAYNE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-17",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A",
        "authorized_official_last_name": "HOLLIDAY",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "ASST CFO",
        "authorized_official_telephone_number": "419-238-0715"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2641R",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0099863",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dee A Russell, LCSW, LCAC, LISW
• James Edward Scarberry
• Manda Schmidt
• Kendra Sentelik
• Vancrest of Payne, LLC
• Village of Payne (Payne Emergency Medical Services)
• Richelle Watters

• Assisted Living Facility in Payne, OH
• Providers in Payne, 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 May 14, 2026; 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.