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General NPI Number Information
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NPI Number | 1043297369
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Entity Type | Organization
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Legal Business Name | HEALTHCARE VENTURES OF OHIO
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Dates
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Enumeration Date | 12/28/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1925 E 4TH ST
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City | OTTAWA
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State | OH
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Zip | 45875-1540
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Country | US
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Telephone | 419-523-4370
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Fax | 419-523-3591
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Provider Business Mailing Address
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Address Line | 1925 E 4TH ST
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City | OTTAWA
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State | OH
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Zip | 45875-1540
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Country | US
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Telephone | 419-523-4370
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Fax | 419-523-3591
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. ERIC IRELAND
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Credential |
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Telephone | 419-523-4370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 1543N
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License Number State | OH
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