Healthcare Provider Details

I. General information

NPI: 1053671297
Provider Name (Legal Business Name): ECHOING HILLS VILLAGE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2012
Last Update Date: 05/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36272 COUNTY ROAD 79
WARSAW OH
43844-9770
US

IV. Provider business mailing address

36272 COUNTY ROAD 79
WARSAW OH
43844-9770
US

V. Phone/Fax

Practice location:
  • Phone: 740-327-2311
  • Fax: 740-327-6371
Mailing address:
  • Phone: 740-327-2311
  • Fax: 740-327-6371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385HR2050X
TaxonomyRespite Care Camp
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN REUBEN SWANSON
Title or Position: EXECUTIVE VICE PRESIDENT
Credential:
Phone: 740-327-2311