Healthcare Provider Details

I. General information

NPI: 1265364517
Provider Name (Legal Business Name): AMBERWOOD MANOR HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 S BROADWAY ST
NEW PHILADELPHIA OH
44663-3842
US

IV. Provider business mailing address

245 S BROADWAY ST
NEW PHILADELPHIA OH
44663-3842
US

V. Phone/Fax

Practice location:
  • Phone: 330-339-2151
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: FACILITY ADMINISTRATOR
Title or Position: ADMINISTRATOR
Credential:
Phone: 330-339-2151