Healthcare Provider Details

I. General information

NPI: 1467451179
Provider Name (Legal Business Name): MILL RUN CARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3399 MILL RUN DR
HILLIARD OH
43026-9078
US

IV. Provider business mailing address

3399 MILL RUN DR
HILLIARD OH
43026-9078
US

V. Phone/Fax

Practice location:
  • Phone: 614-527-3000
  • Fax: 614-527-7199
Mailing address:
  • Phone: 614-527-3000
  • Fax: 614-527-7199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number5279
License Number StateOH

VIII. Authorized Official

Name: SCOTT VAN DE WATER
Title or Position: ADMINISTRATOR
Credential:
Phone: 614-527-3000