Healthcare Provider Details

I. General information

NPI: 1649254608
Provider Name (Legal Business Name): AHF CENTRAL STATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 BELCOURT AVE
NASHVILLE TN
37212-3717
US

IV. Provider business mailing address

4248 TULLER RD
DUBLIN OH
43017-5025
US

V. Phone/Fax

Practice location:
  • Phone: 615-383-3570
  • Fax: 615-460-7778
Mailing address:
  • Phone: 614-760-7352
  • Fax: 614-760-7356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number17940
License Number StateTN

VIII. Authorized Official

Name: MR. MARK T HAEMMERLE
Title or Position: PRESIDENT
Credential: CPA, INACTIVE
Phone: 614-760-7352