Healthcare Provider Details

I. General information

NPI: 1750353363
Provider Name (Legal Business Name): ALTERCARE OF HARTVILLE CENTER FOR REHABILITATION & NURSING CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 10/18/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 SMITH KRAMER ST NE
HARTVILLE OH
44632-8730
US

IV. Provider business mailing address

PO BOX 550
GREEN OH
44232-0550
US

V. Phone/Fax

Practice location:
  • Phone: 330-877-2666
  • Fax:
Mailing address:
  • Phone: 330-498-8101
  • Fax: 330-498-8108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number6059
License Number StateOH

VIII. Authorized Official

Name: MISS KATHLEEN R JOHNSON
Title or Position: VP FINANCE/CONTROLLER
Credential:
Phone: 330-498-5233