Healthcare Provider Details

I. General information

NPI: 1124322813
Provider Name (Legal Business Name): AUTUMN CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2011
Last Update Date: 01/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 PRICE RD
NEWARK OH
43055-3317
US

IV. Provider business mailing address

151 PRICE RD
NEWARK OH
43055-3317
US

V. Phone/Fax

Practice location:
  • Phone: 740-366-2321
  • Fax: 740-366-8600
Mailing address:
  • Phone: 740-366-2321
  • Fax: 740-366-8600

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: STEVEN HITCHENS
Title or Position: PRESIDENT/CEO
Credential:
Phone: 740-345-9199