Healthcare Provider Details

I. General information

NPI: 1952300220
Provider Name (Legal Business Name): THE MACINTOSH COMPANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

391 CLARK DR
CIRCLEVILLE OH
43113-1561
US

IV. Provider business mailing address

391 CLARK DR
CIRCLEVILLE OH
43113-1561
US

V. Phone/Fax

Practice location:
  • Phone: 740-474-6036
  • Fax: 740-420-3342
Mailing address:
  • Phone: 740-474-6036
  • Fax: 740-420-3342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number5388
License Number StateOH

VIII. Authorized Official

Name: CHRISTA KING
Title or Position: ADMINISTRATOR
Credential:
Phone: 740-474-6036