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General NPI Number Information
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NPI Number | 1093378879
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Entity Type | Organization
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Legal Business Name | MH SIDNEY OPERATING, LLC
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Dates
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Enumeration Date | 04/17/2019
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Last Update Date | 04/17/2019
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Provider Practice Location Address
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Address Line | 1150 W RUSSELL RD
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City | SIDNEY
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State | OH
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Zip | 45365-7025
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Country | US
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Telephone | 937-498-1818
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Fax | 937-592-2975
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Provider Business Mailing Address
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Address Line | 1150 W RUSSELL RD
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City | SIDNEY
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State | OH
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Zip | 45365-7025
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Country | US
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Telephone | 937-498-1818
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Fax | 937-592-2975
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Authorized Official
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Title or Position | REIMBURSEMENT ANALYST
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Name | MR. HENRY J VAUGHN
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Credential |
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Telephone | 405-956-0252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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