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General NPI Number Information
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NPI Number | 1194812362
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Entity Type | Organization
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Legal Business Name | ASSUMPTION VILLAGE
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 08/16/2010
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Provider Practice Location Address
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Address Line | 9800 MARKET ST
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City | NORTH LIMA
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State | OH
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Zip | 44452
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Country | US
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Telephone | 330-549-0740
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Fax | 330-549-0701
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Provider Business Mailing Address
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Address Line | 9800 MARKET ST
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City | NORTH LIMA
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State | OH
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Zip | 44452
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Country | US
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Telephone | 330-549-0740
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Fax | 330-549-0701
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. MARY LOU CLATTERBUCK
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Credential |
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Telephone | 330-549-0740
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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 | 5085
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License Number State | OH
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