Healthcare Provider Details

I. General information

NPI: 1285636480
Provider Name (Legal Business Name): MARION HEALTH CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 BELLEFONTAINE AVE
MARION OH
43302-4811
US

IV. Provider business mailing address

26669 BROOKPARK ROAD EXT
NORTH OLMSTED OH
44070-3137
US

V. Phone/Fax

Practice location:
  • Phone: 740-383-2126
  • Fax: 740-383-3689
Mailing address:
  • Phone: 440-614-0160
  • Fax: 440-614-0168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0794N
License Number StateOH

VIII. Authorized Official

Name: BRIAN COLLERAN
Title or Position: PRESIDENT
Credential:
Phone: 440-614-0160