Manor House

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

2449R Issued in OH

Legal business name

MANOR HOUSE

Practice address

204 Archer Dr
Antwerp, OH 45813

Phone

(419) 258-1500

Fax

(419) 258-1509

NPI assigned

Dec 3, 2010

Last updated

Dec 13, 2010By 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

Mrs. Elaine Phillips, LPN

Title

Administrator

Phone

(419) 258-1312

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1291334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292198400000",
    "number": "1861794356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 759",
            "city": "ANTWERP",
            "state": "OH",
            "postal_code": "458130759",
            "telephone_number": "419-258-1500",
            "fax_number": "419-258-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 ARCHER DR",
            "city": "ANTWERP",
            "state": "OH",
            "postal_code": "45813",
            "telephone_number": "419-258-1500",
            "fax_number": "419-258-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANOR HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-03",
        "last_updated": "2010-12-13",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "419-258-1312",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OH",
            "license": "2449R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164327447",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Nicole Gladieux, LCSW
• James Harold Gray Jr., D.O.
• Matthew George Lind Hogan, DO
• Hometown Speech Connections
• Thomas A Hunter, PA-C
• Manor House Transportation L.L.C
• Medoptions
• Miller Pharmaceutical Care, LLC (Antwerp Pharmacy LTC)
• Amanda Marie Miller, PHARMD
• Sarah Jean Mowery, D.D.S.

• Assisted Living Facility in Antwerp, OH
• Providers in Antwerp, 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 Dec 13, 2010; 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.