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FOSTORIA SNF OPCO LLC
NPI 1619846904
Skilled Nursing Facility in Fostoria, OH

Active since November 04, 2025CLIA 36D0859855 · Waiver
1000 INDEPENDENCE AVE, FOSTORIA, OH 44830(419) 435-8505 Get Directions Write a Review

NPPES record last updated: November 4, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Fostoria Snf Opco Llc NPPES

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

FOSTORIA SNF OPCO LLC (NPI 1619846904), doing business as The Independence House Of Fostoria, is a healthcare organization registered as a skilled nursing facility in Fostoria, Ohio and active in the NPI registry since November 2025. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Nicholas Destefane, President, as its authorized official.

NPPES Registry Identity

NPI1619846904
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameFOSTORIA SNF OPCO LLC
Location Address1000 INDEPENDENCE AVEFostoria, OH 44830-9614
Mailing Address1869 Craig Park CtSaint Louis, MO 63146-4122 · (314) 543-3800
Phone(419) 435-8505
Organization SubpartNo
Authorized OfficialNicholas DestefanePresident · (314) 543-3800
Enumeration DateNovember 4, 2025
NPPES CertifiedNovember 4, 2025
✔ NPI 1619846904 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
1000 INDEPENDENCE AVE, Fostoria, OH 44830
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Other Names 1

Doing Business AsThe Independence House Of Fostoria

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 36D0859855

Fostoria Commons, LLC Dba The Independence House · Fostoria, OH
Active · expires Aug 31, 2026
CLIA Number36D0859855
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorAmy Sherer
Laboratory Phone(419) 435-8505
Laboratory LocationFostoria Commons, LLC Dba The Independence House1000 Independence, Fostoria, OH 44830
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

ANGELA ETTER OTD, OTR/L
Occupational Therapist
1000 INDEPENDENCE AVE
FOSTORIA, OH 44830
Seneca County (419) 435-8505
BLANCHARD VALLEY CONTINUING CARE SERVICES
Clinic/Center (Physical Therapy)
1000 INDEPENDENCE AVE
FOSTORIA, OH 44830
Seneca County (419) 435-8505
FOSTORIA AL OPCO LLC
Assisted Living Facility
1000 INDEPENDENCE AVE
FOSTORIA, OH 44830
Seneca County (419) 435-8505
BLANCHARD VALLEY CONTINUING CARE SERVICES
Skilled Nursing Facility
1000 INDEPENDENCE AVE
FOSTORIA, OH 44830
Seneca County (419) 435-8505

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 Fostoria Snf Opco LLC's NPI number?

The NPI number for Fostoria Snf Opco LLC is 1619846904. It was assigned to this organization in the NPPES registry on November 4, 2025. The provider is doing business as The Independence House of Fostoria.

Where is Fostoria Snf Opco LLC located?

Fostoria Snf Opco LLC is located at 1000 Independence Ave, Fostoria, OH 44830. The listed phone number is (419) 435-8505.

What is Fostoria Snf Opco LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Fostoria Snf Opco LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D0859855) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Fostoria Snf Opco LLC was last updated on November 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.