Healthcare Provider Details

I. General information

NPI: 1396749057
Provider Name (Legal Business Name): SHILOH SPRINGS CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 SHILOH SPRINGS RD
TROTWOOD OH
45426-2260
US

IV. Provider business mailing address

3500 SHILOH SPRINGS RD
TROTWOOD OH
45426-2260
US

V. Phone/Fax

Practice location:
  • Phone: 937-854-1180
  • Fax: 937-854-0209
Mailing address:
  • Phone: 937-854-1180
  • Fax: 937-854-0209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number4996
License Number StateOH

VIII. Authorized Official

Name: MR. JOE BARNETT
Title or Position: OWNER
Credential:
Phone: 937-854-1180