Healthcare Provider Details

I. General information

NPI: 1902106784
Provider Name (Legal Business Name): AUTUMN HEALTH CARE OF ADENA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2010
Last Update Date: 11/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 U S ROUTE 250
ADENA OH
43901-7925
US

IV. Provider business mailing address

213 U S ROUTE 250
ADENA OH
43901-7925
US

V. Phone/Fax

Practice location:
  • Phone: 740-546-3620
  • Fax: 740-546-4120
Mailing address:
  • Phone: 740-546-3620
  • Fax: 740-546-4120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: STEVEN HITCHENS
Title or Position: PRESIDENT/CEO
Credential:
Phone: 740-345-9199