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General NPI Number Information
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NPI Number | 1437310208
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Entity Type | Organization
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Legal Business Name | ADCARE HEALTH SYSTEMS INC
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Dates
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Enumeration Date | 06/24/2008
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 75 MOTE DR
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City | COVINGTON
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State | OH
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Zip | 45318-1245
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Country | US
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Telephone | 937-473-2075
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Fax |
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Provider Business Mailing Address
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Address Line | 75 MOTE DR
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City | COVINGTON
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State | OH
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Zip | 45318-1245
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Country | US
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Telephone | 937-473-2075
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. GARY WADE
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Credential |
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Telephone | 937-964-8974
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 36D0717106
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License Number State | OH
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