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General NPI Number Information
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NPI Number | 1003978073
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Entity Type | Organization
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Legal Business Name | ECHOING HILLS VILLAGE, INC.
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 02/19/2015
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Provider Practice Location Address
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Address Line | 175 CHADWICK CT
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City | ELYRIA
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State | OH
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Zip | 44035-4669
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Country | US
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Telephone | 440-323-0915
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Fax | 440-323-7418
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Provider Business Mailing Address
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Address Line | 36272 COUNTY ROAD 79
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City | WARSAW
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State | OH
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Zip | 43844-9770
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Country | US
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Telephone | 740-327-2311
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Fax | 740-327-6371
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT
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Name | MR. JOHN R SWANSON
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Credential |
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Telephone | 740-327-2311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number | 4710647
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License Number State | OH
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