CMS-1500 Box 24J / 33a • NPI
1861794356
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
310400000X
Licensed & Credentialed Assisted Living Facility
Box 32 Service Location & ZIP+4
204 ARCHER DR, ANTWERP, OH, 45813
Official NPPES Practice Location
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1861794356 (MANOR HOUSE) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1861794356 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | MANOR HOUSE |
| Plain-English Specialty | Licensed & Credentialed Assisted Living Facility NUCC Code: 310400000X (Assisted Living Facility) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 204 ARCHER DR, ANTWERP, OH, 45813 |
| Practice Telephone / Fax | Tel: (419) 258-1500 | Fax: (419) 258-1509 |
| Administrative Mailing Address | PO BOX 759, ANTWERP, OH, 45813-0759 |
| Enumeration & Last Sync | Enumerated: 2010-12-03 | CMS Record Updated: 2010-12-13 |
| Authorized Official | ELAINE PHILLIPS (Administrator) |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (310400000X)
What Does Taxonomy Code 310400000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 310400000X translates to:
"Licensed & Credentialed Assisted Living Facility"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (MANOR HOUSE)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
310400000X — Assisted Living FacilityPlain English: Licensed & Credentialed Assisted Living Facility | State: OH | License: 2449R | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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