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General NPI Number Information
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NPI Number | 1174716963
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Entity Type | Organization
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Legal Business Name | SHILOH OF OHIO, LLC
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Dates
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Enumeration Date | 08/24/2007
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Last Update Date | 08/24/2007
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Provider Practice Location Address
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Address Line | 2940 O NEALL RD
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City | WAYNESVILLE
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State | OH
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Zip | 45068-8676
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Country | US
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Telephone | 937-620-8506
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Fax | 513-897-2940
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Provider Business Mailing Address
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Address Line | 2940 O NEALL RD
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City | WAYNESVILLE
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State | OH
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Zip | 45068-8676
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Country | US
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Telephone | 937-620-8506
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Fax | 513-897-2940
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DAWN L. HOLLEY
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Credential | R.N
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Telephone | 937-620-8506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | RN241039
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License Number State | OH
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