Organization
PEREGRINE HEALTH SERVICES OF COLUMBUS LLC
Active
Other names
Summit's Trace Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY PATTON (CFO)
(614) 459-2482
Entity
Organization
Contact information
Practice address
935 N CASSADY AVE, COLUMBUS, OH 43219-2283
(614) 252-4987
(614) 252-5952
Mailing address
1661 OLD HENDERSON RD, COLUMBUS, OH 43220-3644
(614) 459-2656
(614) 459-2641
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
—
314000000X
Skilled Nursing Facility
Primary
1061N
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2912978
—
OH
05
—
2920530
—
OH
Enumeration date
02/10/2009
Last updated
01/24/2019
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