Healthcare Provider Details

I. General information

NPI: 1558420828
Provider Name (Legal Business Name): JACKSON COUNTY HEALTH FACILITIES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 09/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 JENKINS MEMORIAL RD
WELLSTON OH
45692-9561
US

IV. Provider business mailing address

142 JENKINS MEMORIAL RD
WELLSTON OH
45692-9561
US

V. Phone/Fax

Practice location:
  • Phone: 740-384-2119
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number1479R
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1479N
License Number StateOH

VIII. Authorized Official

Name: MR. DAVID NICHOLS
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 740-384-2119