- Enrollment id
- O20240118002123
- Enrollment state
- OH
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1104693456
- Multiple npi flag
- N
- Ccn
- 365344
- Associate id
- 3375995095
- Organization name
- CV OPERATING LLC
- Doing business as name
- LUXE REHABILITATION AND CARE CENTER
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- LUXE REHABILITATION AND CARE CENTER
- Affiliation entity name
- DAVID OBERLANDER
- Affiliation entity id
- 812
- Address line 1
- 957 BECKS KNOB RD
- City
- LANCASTER
- State
- OH
- Zip code
- 431308800