Healthcare Provider Details

I. General information

NPI: 1700712817
Provider Name (Legal Business Name): THE HOMESTEAD OF COSHOCTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48241 GENESIS DRIVE
COSHOCTON OH
43812
US

IV. Provider business mailing address

48241 GENESIS DRIVE
COSHOCTON OH
43812
US

V. Phone/Fax

Practice location:
  • Phone: 740-295-8880
  • Fax: 330-299-8568
Mailing address:
  • Phone: 740-295-8880
  • Fax: 330-299-8568

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: TANA FISCHER
Title or Position: EXECUTIVE DIRECTOR
Credential: RN, CEAL, CDP
Phone: 740-502-6949