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General NPI Number Information
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NPI Number | 1093808529
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Entity Type | Organization
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Legal Business Name | SHEPHERD OF THE VALLEY LUTHERAN RETIREMENT SERVICES, INC.
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 7148 WEST BLVD.
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City | YOUNGSTOWN
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State | OH
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Zip | 44512-4336
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Country | US
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Telephone | 330-726-9061
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Fax |
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Provider Business Mailing Address
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Address Line | 5525 SILICA ROAD
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City | AUSTINTOWN
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State | OH
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Zip | 44515-1002
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Country | US
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Telephone | 330-530-4038
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Fax | 330-530-4039
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Authorized Official
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Title or Position | ASSOCIATE DIRECTOR/CFO
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Name | VICTORIA N. BROWN
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Credential |
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Telephone | 330-530-4038
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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 | 4706
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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