1. Home
  2. Directory
  3. Ohio
  4. Bellaire
  5. Assisted Living Facility
  6. NPI Profile

COUNTRY CLUB RETIREMENT CENTER IV, INC
NPI 1447841572
Assisted Living Facility in Bellaire, OH

Active since February 01, 2021CLIA 36D2011498 · Waiver
3/5
Overall Rating
55801 CONNO MARA DR, BELLAIRE, OH 43906(740) 676-2300 Get Directions Write a Review

NPPES record last updated: February 1, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Country Club Retirement Center Iv, Inc NPPES

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

COUNTRY CLUB RETIREMENT CENTER IV, INC (NPI 1447841572), doing business as County Club Retirement Center, is a healthcare organization registered as an assisted living facility in Bellaire, Ohio and active in the NPI registry since February 2021. The organization holds a CLIA Waiver certificate valid through August 16, 2026 and lists Paul Adamic, Corp Controller, as its authorized official.

NPPES Registry Identity

NPI1447841572
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameCOUNTRY CLUB RETIREMENT CENTER IV, INC
Location Address55801 CONNO MARA DRBellaire, OH 43906-9698
Mailing Address55801 Conno Mara DrBellaire, OH 43906-9698 · (740) 676-2300
Phone(740) 676-2300
Organization SubpartNo
Authorized OfficialPaul AdamicCorp Controller · (330) 239-3597
Enumeration DateFebruary 1, 2021
NPPES CertifiedJanuary 14, 2021
✔ NPI 1447841572 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
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.
55801 CONNO MARA DR, Bellaire, OH 43906
Open in Google Maps ↗

Other Names 1

Doing Business AsCounty Club Retirement Center

Other Identifiers 1

Other1858ROH · Licensure

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 36D2011498

Country Club Retirement Center IV · Bellaire, OH
Active · expires Aug 16, 2026
CLIA Number36D2011498
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateAugust 17, 2024
Certificate Expiration DateAugust 16, 2026
Laboratory DirectorTony Maroni
Laboratory Phone(740) 676-2300
Laboratory LocationCountry Club Retirement Center IV55801 Conno-Mara Drive, Bellaire, OH 43906
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Country Club Retirement Ctr IV (CMS certification number 365699), from CMS Care Compare.

Country Club Retirement Ctr IV

Nursing home · Bellaire, OH
3/5 CMS Overall Rating
OwnershipFor profit - Individual
CMS Certification Number365699
Certified Beds62 beds54 residents per day on average
Medicare & Medicaid Participant SinceJune 23, 1987
Resident & Family CouncilResident council
Continuing care retirement community Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
5/5
Long-Stay Quality
Quality of care delivered to long-term residents.
5/5
Short-Stay Quality
Quality of care delivered to short-term and rehabilitation residents.
2/5
Staffing
Based on nursing staff hours relative to resident needs.
3/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
69.67
Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing
nurse aide 2.11 · LPN 0.61 · RN 0.67
3.39 hrs per resident per day
Weekend Nurse Staffing
3.08 hrs per resident per day
Physical Therapist Staffing
0.05 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
41.5%
Registered Nurse Turnover
30%
Administrators Who Have Left
In the past year.
1
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
0
Substantiated Complaints
5
Fines
0
Medicare Payment Denials
0
Total Penalties
0
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Other Providers at the Same Location NPPES

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

COUNTRY CLUB RETIREMENT CENTER IV, INC
Skilled Nursing Facility
55801 CONNO MARA DR
BELLAIRE, OH 43906
Belmont County (800) 516-9389

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 Country Club Retirement Center IV, Inc's NPI number?

The NPI number for Country Club Retirement Center IV, Inc is 1447841572. It was assigned to this organization in the NPPES registry on February 1, 2021. The provider is doing business as County Club Retirement Center.

Where is Country Club Retirement Center IV, Inc located?

Country Club Retirement Center IV, Inc is located at 55801 Conno Mara Dr, Bellaire, OH 43906. The listed phone number is (740) 676-2300.

What is Country Club Retirement Center IV, Inc's specialty?

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

Does Country Club Retirement Center IV, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D2011498) is associated with this NPI, valid through August 16, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Country Club Retirement Center IV, Inc a Medicare-certified nursing home?

Yes. Country Club Retirement Ctr IV is a Medicare-certified nursing home with 62 certified beds.

What quality rating does Country Club Retirement Center IV, Inc have?

CMS rates Country Club Retirement Ctr IV 3 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

When was this NPI record last updated?

The NPPES record for Country Club Retirement Center IV, Inc was last updated on February 1, 2021. 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.