MEDICARE: THE MARIA-JOSEPH CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	3574	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982635066
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE MARIA-JOSEPH CENTER

Provider Business Mailing Address
First Line	:	4830 SALEM AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45416-1798
Country	:	US
Telephone Number	:	937-278-2692
Fax Number	:	937-278-9016

Provider Business Practice Location Address
First Line	:	4830 SALEM AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45416-1798
Country	:	US
Telephone Number	:	937-278-2692
Fax Number	:	937-278-9016

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MS. SHARON K THORNTON
Credential	:	LNHA
Telephone Number	:	937-278-2692

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	01/30/2009

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Directions to “THE MARIA-JOSEPH CENTER ” Practice Location

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