Healthcare Provider Details

I. General information

NPI: 1255609467
Provider Name (Legal Business Name): SOLID ROCK ADULT DAY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2011
Last Update Date: 12/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10911 MARKET AVE NW
UNIONTOWN OH
44685-7669
US

IV. Provider business mailing address

10911 MARKET AVE NW
UNIONTOWN OH
44685-7669
US

V. Phone/Fax

Practice location:
  • Phone: 330-990-1777
  • Fax: 330-877-1996
Mailing address:
  • Phone:
  • Fax: 330-877-1996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number2043830
License Number StateOH

VIII. Authorized Official

Name: MS. NADINE LYNN VONGUNTEN
Title or Position: PRESIDENT
Credential:
Phone: 330-990-1777