- Enrollment id
- O20220103000473
- Enrollment state
- OH
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1467116210
- Multiple npi flag
- N
- Ccn
- 365731
- Associate id
- 6608267539
- Organization name
- EAST PARK OPERATIONS LLC
- Doing business as name
- EAST PARK CARE CENTER
- Incorporation date
- 2021-04-13
- Incorporation state
- OH
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- EAST PARK CARE CENTER
- Affiliation entity name
- LIONSTONE CARE
- Affiliation entity id
- 611
- Address line 1
- 8 E PARK CIR
- City
- BROOKPARK
- State
- OH
- Zip code
- 441423800