Organization Active NPI

Pristine Senior Living of Toledo, LLC

  • Skilled Nursing Facility
  • Toledo, OH
National Provider Identifier
1831574706
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
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

Updated by the provider on Jul 21, 2015

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2724538MedicaidOH

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.