BLC Springfield-GC, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

1986R Issued in OH

Legal business name

BLC SPRINGFIELD-GC, LLC

Doing business as

Grand Court Springfield

Practice address

2981 Vester Ave
Springfield, OH 45503-1565

Phone

(937) 399-1216

NPI assigned

Jul 27, 2007

Last updated

Jul 27, 2007By 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

Mr. Mark J Schulte

Title

Ceo

Phone

(312) 977-3700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Grand Court Springfield Doing business as

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185494400000",
    "number": "1831389691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2981 VESTER AVE",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455031565",
            "telephone_number": "937-399-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2981 VESTER AVE",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455031565",
            "telephone_number": "937-399-1216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLC SPRINGFIELD-GC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-27",
        "last_updated": "2007-07-27",
        "status": "A",
        "authorized_official_last_name": "SCHULTE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "312-977-3700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OH",
            "license": "1986R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "APPLIED FOR",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Court Springfield",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Springfield, OH
• Providers in Springfield, 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 Jul 27, 2007; 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.