Healthcare Provider Details

I. General information

NPI: 1942376868
Provider Name (Legal Business Name): HEALTHCARE VENTURES OF OHIO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 09/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 E 4TH ST
OTTAWA OH
45875-1540
US

IV. Provider business mailing address

1661 OLD HENDERSON RD
COLUMBUS OH
43220-3644
US

V. Phone/Fax

Practice location:
  • Phone: 419-523-4370
  • Fax: 419-523-3591
Mailing address:
  • Phone: 614-459-2482
  • Fax: 614-459-2641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1543N
License Number StateOH

VIII. Authorized Official

Name: OSCAR G ALEMAN
Title or Position: CONTROLLER
Credential:
Phone: 614-459-2482