Organization
SENIORLIFESTYLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE SCHRENKER (LPN)
(513) 948-2339
Entity
Organization
Contact information
Practice address
8000 EVERGREEN RIDGE DR, CINCINNATI, OH 45215-5750
(513) 948-2308
Mailing address
325 KNOLLRIDGE CT, APT, FAIRFIELD, OH 45014-8809
(513) 600-1596
Taxonomy
Speciality
Code
Description
License number
State
282E00000X
Long Term Care Hospital
148696
OH
311ZA0620X
Adult Care Home Facility
Primary
148696
OH
311ZA0620X
Adult Care Home Facility
27068634A
IN
314000000X
Skilled Nursing Facility
148696
OH
3140N1450X
Pediatric Skilled Nursing Facility
148696
OH
385H00000X
Respite Care
148696
OH
385H00000X
Respite Care
27068634A
IN
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
27068634A
IN
Other
Enumeration date
06/24/2013
Last updated
06/24/2013
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