Active NPI
Wellington Estates Inc
Doing business as Boardwalk & Parkplace
- Intellectual Disabilities Intermediate Care Facility
- Wellington, OH
National Provider Identifier
1790943538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual Disabilities Intermediate Care Facility
- Legal business name
- WELLINGTON ESTATES INC
- Doing business as
- Boardwalk & Parkplace
- Practice address
- 103-110 Weber CT
Wellington, OH 44090 - Phone
- (440) 647-2088
- NPI assigned
- May 29, 2008
- Last updated
- May 29, 2008
- 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
- Mr. Adelbert H Weber
- Title
- Administrator
- Phone
- (440) 647-2088
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | Primary |
Addresses
Primary practice location
103-110 Weber CT
Wellington, OH 44090
Mailing address
PO Box 386
Wellington, OH 44090-0386
Phone (440) 647-2088
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4710576 | Other | OH | ODMR/DD FACILITY NO. |
| 36-G447 | Other | OH | MEDICARE PROVIDER NO. |
| 0880800 | Other | OH | MEDICADE PROVIDER NO. |
| 25845 | Other | OH | MR/DD LICENSE NO. |
Other names 1
- BOARDWALK & PARKPLACE
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1790943538. Details of each certification follow.
Intermediate care facility for individuals with intellectual disabilities certification: CCN 36G447
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- RESCARE OHIO BOARDWALK/PARKPLACE
- Certification status
- Active
- Provider type (POS)
- Intermediate care facility for individuals with intellectual disabilities
- Participating since
- Jun 10, 1992
- Last certification
- Nov 13, 2025
- Beds
- 18
- Ownership / control type
- Private (proprietary)
- Facility address
- 103-110 Weber Court
Wellington, OH 44090
National Provider Directory
National Provider Directory- Tax ID family
- Boardwalk Parkplace
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba St Charles/St James Place
- Intellectual Disabilities Intermediate Care Facility
- Wellington, OH
- NPI 1144488099
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212019200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1212019200000",
"number": "1790943538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 386",
"city": "WELLINGTON",
"state": "OH",
"postal_code": "440900386",
"telephone_number": "440-647-2088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103-110 WEBER CT",
"city": "WELLINGTON",
"state": "OH",
"postal_code": "44090",
"telephone_number": "440-647-2088"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WELLINGTON ESTATES INC",
"organizational_subpart": "NO",
"enumeration_date": "2008-05-29",
"last_updated": "2008-05-29",
"status": "A",
"authorized_official_last_name": "WEBER",
"authorized_official_first_name": "ADELBERT",
"authorized_official_middle_name": "H",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "440-647-2088",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "315P00000X",
"taxonomy_group": "",
"desc": "Intermediate Care Facility, Intellectual Disabilities",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ODMR/DD FACILITY NO.",
"identifier": "4710576",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PROVIDER NO.",
"identifier": "36-G447",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICADE PROVIDER NO.",
"identifier": "0880800",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MR/DD LICENSE NO.",
"identifier": "25845",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "BOARDWALK & PARKPLACE",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Wellington, OH
- Lori Renee Waite, LPN
- Courtney A Wallace, STNA
- Michelle Marie Wallace I, R.N.
- Weber Health Care Center, Inc.
- Wellington Estates Inc (St Charles/St James Place)
- Wellington Exempted Village School District
- Wellington Manor Nursing Home Inc
- Laura Joyce White
- Whitney Home Care, LLC
- Shana Danielle Williams
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.