Healthcare Provider Details

I. General information

NPI: 1164603494
Provider Name (Legal Business Name): CENTERBURG POINTE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2007
Last Update Date: 02/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25326 SNIVELY RD
DANVILLE OH
43014-9761
US

IV. Provider business mailing address

25326 SNIVELY RD
DANVILLE OH
43014-9761
US

V. Phone/Fax

Practice location:
  • Phone: 740-599-6357
  • Fax: 740-599-5692
Mailing address:
  • Phone: 740-599-6357
  • Fax: 740-599-5692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. JAMES ANTHONY GRIFFITHS
Title or Position: PRESIDENT
Credential:
Phone: 440-333-2132