BROOKDALE KETTERING
NPI 1063754711
Assisted Living Facility in Beavercreek Township, OH

Q: What is Blc Dayton Gc LLC's NPI number?

The NPI number for Blc Dayton Gc LLC is 1063754711. It was assigned to this organization in the NPPES registry on March 20, 2013. The provider is doing business as Brookdale Kettering.

Q: What is Blc Dayton Gc LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Q: When was this NPI record last updated?

The NPPES record for Blc Dayton Gc LLC was last updated on November 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 20, 2013CLIA 36D2070487 · Waiver

280 WALDEN WAY, BEAVERCREEK TOWNSHIP, OH 45440(937) 427-0060 Get Directions Write a Review

NPPES record last updated: November 17, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 17, 2020, Oct 8, 2018 (2 updates tracked since 2018).

On this page

About Brookdale Kettering NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROOKDALE KETTERING (NPI 1063754711) is a healthcare organization registered as an assisted living facility in Beavercreek Township, Ohio and active in the NPI registry since March 2013. The organization holds a CLIA Waiver certificate valid through December 17, 2027 and lists Joanne Leskowicz, Senior Vice President, as its authorized official.

NPPES Registry Identity

NPI1063754711

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameBLC DAYTON GC LLC

Location Address280 WALDEN WAYBeavercreek Township, OH 45440-4461

Mailing Address280 Walden WayDayton, OH 45440-4461 · (937) 427-0060

Phone(937) 427-0060

Organization SubpartYesParent: Brookdale Senior Living Inc

Authorized OfficialJoanne LeskowiczSenior Vice President · (414) 918-5000

Enumeration DateMarch 20, 2013

Last NPPES UpdateNovember 17, 20202 updates tracked since enumeration

NPPES CertifiedNovember 17, 2020

✔ NPI 1063754711 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

License✔ Licensed in OH · 2078R

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

280 WALDEN WAY, Beavercreek Township, OH 45440

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Other Names 1

Doing Business AsBrookdale Kettering

Other Identifiers 1

Medicaid0098533OH

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D2070487

Brookdale Kettering · Dayton, OH

Active · expires Dec 17, 2027

CLIA Number36D2070487

Laboratory TypeAssisted Living Facility

Certificate Effective DateDecember 18, 2025

Certificate Expiration DateDecember 17, 2027

Laboratory DirectorTiffany S. Bolin

Laboratory Phone(937) 427-0060

Laboratory LocationBrookdale Kettering280 Walden Way, Dayton, OH 45440

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AEGIS GROUP PRACTICE LLC

Physical Therapist

280 WALDEN WAY
DAYTON, OH 45440

Montgomery County (479) 201-6091

EMILY CHRISTINE DAYTON OTD

Occupational Therapist

280 WALDEN WAY
DAYTON, OH 45440

Montgomery County (937) 427-0060

BKD PERSONAL ASSISTANCE SERVICES LLC

In Home Supportive Care

280 WALDEN WAY
BEAVERCREEK TOWNSHIP, OH 45440

Montgomery County (937) 490-3139

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blc Dayton Gc LLC's NPI number?

The NPI number for Blc Dayton Gc LLC is 1063754711. It was assigned to this organization in the NPPES registry on March 20, 2013. The provider is doing business as Brookdale Kettering.

Where is Blc Dayton Gc LLC located?

Blc Dayton Gc LLC is located at 280 Walden Way, Beavercreek Township, OH 45440. The listed phone number is (937) 427-0060.

What is Blc Dayton Gc LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Blc Dayton Gc LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D2070487) is associated with this NPI, valid through December 17, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Blc Dayton Gc LLC was last updated on November 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.