| NPI | 1356370472 |
|---|---|
| Doing Business As | COUNTRYSIDE CONTINUING CARE CENTER |
| Entity Type | Organization |
| Authorized Contact | LINDA BLACK-KUREK President 937-296-1550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric (Licence: OH 6160) |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2013-06-13 |