Active NPI
Pristine Senior Living of Toledo, LLC
- Skilled Nursing Facility
- Toledo, OH
National Provider Identifier
1831574706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- PRISTINE SENIOR LIVING OF TOLEDO, LLC
- Practice address
- 2051 Collingwood Blvd
Toledo, OH 43620-1649 - Phone
- (419) 243-5191
- NPI assigned
- Jul 21, 2015
- 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. Christopher T Cook
- Title
- Chief Executive Officer
- Phone
- (317) 408-8491
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | OH | Primary |
Addresses
Primary practice location
2051 Collingwood Blvd
Toledo, OH 43620-1649
Mailing address
3301 W Purdue Ave
Muncie, IN 47304-6356
Phone (317) 408-8491
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2724538 | Medicaid | OH |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437436800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1437436800000",
"number": "1831574706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3301 W PURDUE AVE",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473046356",
"telephone_number": "317-408-8491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2051 COLLINGWOOD BLVD",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436201649",
"telephone_number": "419-243-5191"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PRISTINE SENIOR LIVING OF TOLEDO, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-07-21",
"last_updated": "2015-07-21",
"status": "A",
"authorized_official_last_name": "COOK",
"authorized_official_first_name": "CHRISTOPHER",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "317-408-8491",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "OH",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2724538",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.