Healthcare Provider Details

I. General information

NPI: 1578566782
Provider Name (Legal Business Name): HOLANDER HOUSE, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 11/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1985 EAST PERSHING STREET
SALEM OH
44460-0000
US

IV. Provider business mailing address

1985 EAST PERSHING STREET
SALEM OH
44460-0000
US

V. Phone/Fax

Practice location:
  • Phone: 330-332-1588
  • Fax: 330-332-3119
Mailing address:
  • Phone: 330-332-1588
  • Fax: 330-332-3119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1140-N
License Number StateOH

VIII. Authorized Official

Name: ALAN SCHWARTZ
Title or Position: CEO/SALEM HEALTHCARE MANAGEMENT
Credential:
Phone: 330-332-1588