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General NPI Number Information
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NPI Number | 1386450948
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Entity Type | Organization
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Legal Business Name | WEST LIBERTY CARE CENTER, INC.
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Dates
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Enumeration Date | 12/09/2024
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 6557 US HIGHWAY 68 S
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City | WEST LIBERTY
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State | OH
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Zip | 43357-9536
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Country | US
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Telephone | 937-465-5065
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Fax |
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Provider Business Mailing Address
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Address Line | 6557 US HIGHWAY 68 S
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City | WEST LIBERTY
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State | OH
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Zip | 43357-9536
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Country | US
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Telephone | 937-465-5065
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MICHAEL S RAY
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Credential |
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Telephone | 937-650-7103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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