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General NPI Number Information
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NPI Number | 1295169100
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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 | 08/27/2013
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Last Update Date | 08/25/2020
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Provider Practice Location Address
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Address Line | 1501 TIBBETTS WICK RD
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City | GIRARD
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State | OH
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Zip | 44420-1206
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Country | US
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Telephone | 330-544-0771
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Fax |
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Provider Business Mailing Address
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Address Line | 5525 SILICA RD
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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 | C.F.O.
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Name | VICTORIA 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 | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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