DIVERSICARE OF AVON, LLC (NPI# 1891102760) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891102760 |
| Entity Type | Organization |
| Organization Name | DIVERSICARE OF AVON, LLC |
| Other Organization Name | AVON PLACE |
| Practice Address |
32900 Detroit Rd Avon OH 44011-2018 |
| Practice Telephone | 4409376201 |
| Practice Fax Number | 4409375955 |
| Mailing Telephone | 4409376201 |
| Mailing Fax Number | 4409375955 |
| Enumeration Date | 2014-07-12 |
| Last Update Date | 2014-07-12 |
| Authorized Official Name | KELLY J GILL (PRESIDENT AND CEO) |
| Authorized Official Telephone | 6157717575 |
| Is Organization Subpart | Y |
| Parent Organization Name | DIVERSICARE LEASING COMPANY II, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Avon Place | Doing Business As Name - Organization |
| Street Address |
32900 DETROIT RD |
| City | AVON |
| State | OH |
| Zip Code | 44011-2018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962528422 | Good Samaritan Health Group, Inc | Skilled Nursing Facility | 32900 Detroit Rd, Avon, OH 44011-2018 | 2007-03-22 |
| 1588010300 | Cardinal Avon, Inc. | Skilled Nursing Facility | 32900 Detroit Rd, Avon, OH 44011-2018 | 2016-05-11 |
| 1982061560 | Kathryn F Senft | Speech-Language Pathologist | 32900 Detroit Rd, Avon, OH 44011-2018 | 2016-01-27 |
| 1427415975 | Katherine Diane Budaji | Physical Therapist | 32900 Detroit Rd, Avon, OH 44011-2018 | 2016-01-27 |
| 1992034516 | Westshore Primary Care Assoc., Inc. | Dermatology | 32900 Detroit Rd, Avon, OH 44011-2018 | 2009-12-10 |
| 1720312069 | The Foot and Ankle Clinic LLC | Clinic/Center | 32900 Detroit Rd, Avon, OH 44011-2018 | 2009-09-18 |
| 1982807954 | Good Samaritan Nursing Home, LLC | Skilled Nursing Facility | 32900 Detroit Rd, Avon, OH 44011-2018 | 2007-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750845889 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 1810 Nagel Rd, Avon, OH 44011 | 2019-01-23 |
| 1548758782 | Stacey L Yanetta | Social Worker | Avon-richard E. Jacobs Health Center, 33100 Cleveland Clinic Blvd, Avon, OH 44011 | 2018-04-24 |
| 1073054540 | Timothy Weitzel | Social Worker | 36419 Edenhall Terrace, Avon, OH 44011 | 2017-03-16 |
| 1568829059 | Jessica Ryan Springer | Nurse Practitioner | 36130 N Park Dr, Avon, OH 44011 | 2016-01-28 |
| 1962879569 | Cleveland Clinic Rehabilitation Hospitals, LLC | Rehabilitation Hospital | 33355 Health Campus Boulevard, Avon, OH 44011 | 2015-08-31 |
| 1619373024 | Avon Healthcare Center, Inc. | Skilled Nursing Facility | 37845 Colorado Avenue, Avon, OH 44011 | 2014-11-12 |
| 1508272543 | Samantha Willi | Counselor | 37040 Colorado Ave, Avon, OH 44011 | 2014-07-10 |
| 1336572791 | Todd Bernard | Dentist | 37701 Colorado Ave Ste E, Avon, OH 44011 | 2013-08-20 |
| 1245550730 | Kenneth Charles Hohmeier | Pharmacist | 38530 Chester Road, Suite 400, Avon, OH 44011 | 2010-06-07 |
| 1760712343 | Avon Local School District | Local Education Agency (LEA) | 36600 Detroit Road, Avon, OH 44011 | 2010-01-05 |
| Find all providers in zip 44011 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619373024 | Avon Healthcare Center, Inc. | Skilled Nursing Facility | 37845 Colorado Avenue, Avon, OH 44011 | 2014-11-12 |
| 1598192957 | Daviess County Hospital | Skilled Nursing Facility | 1108 Kingwood Drive, Avon, IN 46123-5500 | 2013-10-01 |
| 1396189460 | Masonicare | Skilled Nursing Facility | 15 Arlington Dr, Avon, CT 06001 | 2013-04-19 |
| 1063717528 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 762 N Dan Jones Rd, Avon, IN 46123 | 2011-01-13 |
| 1427284629 | Ann N Noblitt | Skilled Nursing Facility | 4171 Forest Point Cir, Avon, IN 46123-6668 | 2009-06-03 |
| 1962528422 | Good Samaritan Health Group, Inc | Skilled Nursing Facility | 32900 Detroit Rd, Avon, OH 44011-2018 | 2007-03-22 |
| 1841385804 | Brightview Nursing & Retirement Center Ltd. | Skilled Nursing Facility | 220 Scoville Road, Avon, CT 06001 | 2006-10-04 |
| 1619083235 | Riverview Hospital | Skilled Nursing Facility | 4171 Forest Pointe Circle, Avon, IN 46123 | 2006-08-23 |
| 1629004395 | Avon Convalescent Home, Inc. | Skilled Nursing Facility | 652 W Avon Rd, Avon, CT 06001-2906 | 2006-06-24 |
| 1326082009 | Hendricks County Hospital | Skilled Nursing Facility | 445 South S. County Rd 525 E, Avon, IN 46123 | 2006-06-15 |
| Find all providers in AVON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.