Healthcare Provider Details

I. General information

NPI: 1144348285
Provider Name (Legal Business Name): FRIENDLY NURSING HOME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 01/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 ASTORIA RD
GERMANTOWN OH
45327-1712
US

IV. Provider business mailing address

PO BOX 190 300 ASTORIA ROAD
GERMANTOWN OH
45327-0190
US

V. Phone/Fax

Practice location:
  • Phone: 937-855-2363
  • Fax: 937-855-4679
Mailing address:
  • Phone: 937-855-2363
  • Fax: 937-855-4679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number5137
License Number StateOH

VIII. Authorized Official

Name: BARBARA LINDSEY
Title or Position: ADMINISTRATOR
Credential:
Phone: 937-855-2363