5440 Charlesgate Road Operating Company, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

5440 CHARLESGATE ROAD OPERATING COMPANY, LLC

Doing business as

Huber Heights Health Care Center

Practice address

5440 Charlesgate Rd
Huber Heights, OH 45424-1049

Phone

(937) 236-6707

NPI assigned

Aug 31, 2006

Last updated

Aug 22, 2020By 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. Kevin P Breslin

Title

Executive Vice President - Cfo

Phone

(201) 242-4000

Specialties & licenses 1

Addresses

Other names 1

• Huber Heights Health Care Center Doing business as

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881706976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5440 CHARLESGATE RD",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454241049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 CHARLESGATE RD",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454241049",
            "telephone_number": "937-236-6707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "5440 CHARLESGATE ROAD OPERATING COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRESLIN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT - CFO",
        "authorized_official_telephone_number": "201-242-4000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Huber Heights Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.