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General NPI Number Information
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NPI Number | 1356613350
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Entity Type | Organization
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Legal Business Name | WILLIAMGABLE
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Dates
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Enumeration Date | 02/07/2012
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 137 S KENNEBEC AVE
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City | MCCONNELSVILLE
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State | OH
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Zip | 43756-1211
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Country | US
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Telephone | 740-962-5727
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Fax | 740-962-5727
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Provider Business Mailing Address
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Address Line | 137 S KENNEBEC AVE
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City | MCCONNELSVILLE
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State | OH
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Zip | 43756-1211
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Country | US
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Telephone | 740-962-5727
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Fax | 740-962-6393
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. LORI ANN ALLEN
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Credential |
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Telephone | 740-962-5727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State | OH
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