Healthcare Provider Details

I. General information

NPI: 1669478269
Provider Name (Legal Business Name): OHIO VALLEY MANOR, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 07/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5280 RTS 62-68
RIPLEY OH
45167
US

IV. Provider business mailing address

5280 RTS 62-68
RIPLEY OH
45167
US

V. Phone/Fax

Practice location:
  • Phone: 937-392-4318
  • Fax: 937-392-4568
Mailing address:
  • Phone: 937-392-4318
  • Fax: 937-392-4568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1990
License Number StateOH

VIII. Authorized Official

Name: MRS. KAREN R GESCHWIND
Title or Position: CONTROLLER
Credential: CPA
Phone: 937-392-4318