| NPI | 1093948127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERANDA LYNNETTE MILLER Licensed Practical Nurse 937-242-6265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: OH 135359) |
| Additional Taxonomies | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric (Licence: OH 135359) |
| 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: OH 135359) | |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2009-08-24 |