- Enrollment id
- O20150417000269
- Enrollment state
- OH
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1720476625
- Multiple npi flag
- N
- Ccn
- 365690
- Associate id
- 4082932389
- Organization name
- CV HEALTHCARE LLC
- Doing business as name
- CEDARVIEW CARE CENTER
- Incorporation date
- 2014-09-23
- Incorporation state
- DE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- CEDARVIEW CARE CENTER
- Affiliation entity name
- CCH HEALTHCARE
- Affiliation entity id
- 124
- Address line 1
- 115 OREGONIA RD
- City
- LEBANON
- State
- OH
- Zip code
- 450361983