| NPI | 1275507998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY WOODROW SHACKLEFORD Administrator 330-682-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: OH 5755) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2020-08-22 |