Provider Demographics
NPI:1285095893
Name:CHI LIVING COMMUNITIES
Entity type:Organization
Organization Name:CHI LIVING COMMUNITIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:DOLYK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:567-455-0414
Mailing Address - Street 1:2345 AMSTERDAM RD
Mailing Address - Street 2:
Mailing Address - City:VILLA HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3711
Mailing Address - Country:US
Mailing Address - Phone:859-426-6400
Mailing Address - Fax:
Practice Address - Street 1:2345 AMSTERDAM RD
Practice Address - Street 2:
Practice Address - City:VILLA HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3711
Practice Address - Country:US
Practice Address - Phone:859-426-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-09
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY185241Medicare Oscar/Certification