Healthcare Provider Details

I. General information

NPI: 1427066299
Provider Name (Legal Business Name): HUSTON NURSING HOME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38500 STATE ROUTE 160
HAMDEN OH
45634-8805
US

IV. Provider business mailing address

38500 STATE ROUTE 160
HAMDEN OH
45634-8805
US

V. Phone/Fax

Practice location:
  • Phone: 740-384-3485
  • Fax: 740-384-3324
Mailing address:
  • Phone: 740-384-3485
  • Fax: 740-384-3324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License NumberOH00504
License Number StateOH

VIII. Authorized Official

Name: MARJORIE HUSTON
Title or Position: NURSING ADMINISTRATOR
Credential:
Phone: 740-384-3485