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General NPI Number Information
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NPI Number | 1225270556
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Entity Type | Organization
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Legal Business Name | FIDLAY RETIREMENT, LLC
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Dates
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Enumeration Date | 04/01/2009
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Last Update Date | 04/01/2009
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Provider Practice Location Address
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Address Line | 8580 TOWNSHIP ROAD 237
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City | FINDLAY
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State | OH
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Zip | 45840
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Country | US
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Telephone | 419-422-6200
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Fax | 419-422-6230
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Provider Business Mailing Address
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Address Line | 8580 TOWNSHIP ROAD
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City | FINDLAY
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State | OH
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Zip | 45840
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Country | US
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Telephone | 419-422-6200
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Fax | 419-422-6230
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Authorized Official
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Title or Position | DIRECTOR OF NURSING
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Name | MS. BONNIE JEAN KELLY
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Credential | REGISTERED NURSE
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Telephone | 605-226-3300
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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 | 2483R
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License Number State | OH
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