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General NPI Number Information
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NPI Number | 1255332862
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Entity Type | Organization
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Legal Business Name | ROSEWOOD MANOR
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Dates
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Enumeration Date | 08/04/2005
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Last Update Date | 08/18/2008
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Provider Practice Location Address
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Address Line | 214 4TH ST
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City | YORKVILLE
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State | OH
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Zip | 43971-1212
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Country | US
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Telephone | 740-859-6496
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Fax | 740-859-7120
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Provider Business Mailing Address
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Address Line | PO BOX 6230
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City | WHEELING
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State | WV
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Zip | 26003-0722
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Country | US
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Telephone | 304-242-7106
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Fax | 304-242-7108
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Authorized Official
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Title or Position | OWNER
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Name | MARY DAVIS
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Credential |
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Telephone | 740-859-6496
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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 |
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License Number State | OH
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