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General NPI Number Information
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NPI Number | 1053790287
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Entity Type | Organization
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Legal Business Name | THE STABLES AT ROSE OF SHARON
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Dates
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Enumeration Date | 05/20/2015
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Last Update Date | 05/20/2015
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Provider Practice Location Address
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Address Line | 1021 RIDGEWOOD RD
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City | WADSWORTH
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State | OH
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Zip | 44281-9711
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Country | US
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Telephone | 330-697-4382
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Fax |
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Provider Business Mailing Address
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Address Line | 1021 RIDGEWOOD RD
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City | WADSWORTH
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State | OH
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Zip | 44281-9711
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Country | US
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Telephone | 330-697-4382
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JILLIAN DEENA PELLAND
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Credential | OTR/L
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Telephone | 330-697-4382
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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