CCN: 365699 NPI: 1881747673 Organization

COUNTRY CLUB RETIREMENT CTR IV

55801 CONNO MARA DR
BELLAIRE, OH 439069698

Contact Information

Phone 8005169389
Fax 7406761277
Enumeration Date 2007-01-18
Last Updated 2012-04-16

Taxonomies

Code: 310400000X License State: OH License: 1858R
Code: 314000000X (Primary) License State: OH License: 3761

Inpatient Payment Attributes (IPSF) View Dictionary →

Effective Date:

censusDivision 4

cbsaActualGeographicLocation 48540

providerType 38

vbpAdjustment 0.9955239978

censusDivision 4

cbsaActualGeographicLocation 48540

providerType 38

vbpAdjustment 0.9802564842

censusDivision 0

cbsaActualGeographicLocation 48540

providerType 38

vbpAdjustment 0.9802538758

censusDivision 0

cbsaActualGeographicLocation 48540

providerType 38

vbpAdjustment 0.992

censusDivision 0

cbsaActualGeographicLocation 48540

providerType 38

vbpAdjustment 0.992

censusDivision 0

cbsaActualGeographicLocation 48540

providerType 38

vbpAdjustment 0.980278308

censusDivision 0

cbsaActualGeographicLocation 48540

providerType 38

vbpAdjustment 0.9848671958

censusDivision 0

cbsaActualGeographicLocation 48540

providerType 38

vbpAdjustment 0.9825896122

Outpatient Payment Attributes (OPSF) View Dictionary →

No OPSF records found for this provider.