Healthcare Provider Details

I. General information

NPI: 1962508069
Provider Name (Legal Business Name): WAVERLY CARE CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 CHERRY ST
WAVERLY OH
45690
US

IV. Provider business mailing address

5475 RINGS RD STE 300
DUBLIN OH
43017-7537
US

V. Phone/Fax

Practice location:
  • Phone: 740-947-2113
  • Fax: 740-947-1854
Mailing address:
  • Phone: 614-451-2151
  • Fax: 614-442-7040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number4884
License Number StateOH

VIII. Authorized Official

Name: BRIANNA METTLER
Title or Position: PRESIDENT
Credential:
Phone: 614-451-2151