Healthcare Provider Details

I. General information

NPI: 1104161595
Provider Name (Legal Business Name): HCF OF BOWLING GREEN CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2012
Last Update Date: 04/29/2020
Certification Date: 04/29/2020
Deactivation Date: 03/13/2020
Reactivation Date: 04/29/2020

III. Provider practice location address

850 W POE RD
BOWLING GREEN OH
43402-1219
US

IV. Provider business mailing address

850 W POE RD
BOWLING GREEN OH
43402-1219
US

V. Phone/Fax

Practice location:
  • Phone: 419-352-7558
  • Fax:
Mailing address:
  • Phone: 419-352-7558
  • Fax: 419-354-9501

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: MR. RYAN STECHSCHULTE
Title or Position: DIRECTOR - CORPORATE COMPLIANCE
Credential:
Phone: 419-999-2010