Healthcare Provider Details

I. General information

NPI: 1932238854
Provider Name (Legal Business Name): DAYTON SENIOR CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 03/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5790 DENLINGER RD
DAYTON OH
45426-1838
US

IV. Provider business mailing address

5790 DENLINGER RD
DAYTON OH
45426-1838
US

V. Phone/Fax

Practice location:
  • Phone: 937-837-5581
  • Fax: 937-854-8203
Mailing address:
  • Phone: 937-837-5581
  • Fax: 937-854-8203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1578
License Number StateOH

VIII. Authorized Official

Name: CHRISTIN J ROSE
Title or Position: CHAIRMAN
Credential:
Phone: 423-584-6755