Healthcare Provider Details

I. General information

NPI: 1023608486
Provider Name (Legal Business Name): GARDENS AT CELINA OPERATING COMPANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2021
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 MYERS RD
CELINA OH
45822-4114
US

IV. Provider business mailing address

1301 MYERS RD
CELINA OH
45822-4114
US

V. Phone/Fax

Practice location:
  • Phone: 419-584-0100
  • Fax:
Mailing address:
  • Phone: 419-584-0100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFFREY DEGYANSKY
Title or Position: VICE PRESIDENT OF OPERATIONS
Credential: LNHA
Phone: 330-620-7828