Healthcare Provider Details

I. General information

NPI: 1073585600
Provider Name (Legal Business Name): ALTERCARE OF VALLEY VIEW NURSING HOME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 05/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5185 LITHOPOLIS RD NW
LANCASTER OH
43130-7985
US

IV. Provider business mailing address

339 E MAPLE ST SUITE 100
NORTH CANTON OH
44720-2593
US

V. Phone/Fax

Practice location:
  • Phone: 740-687-0050
  • 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 Number6273
License Number StateOH

VIII. Authorized Official

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