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General NPI Number Information
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NPI Number | 1457744013
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Entity Type | Organization
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Legal Business Name | SKILLSMED INC.
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Dates
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Enumeration Date | 03/06/2015
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Last Update Date | 03/06/2015
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Provider Practice Location Address
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Address Line | 1156 W WESTERN RESERVE RD
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City | YOUNGSTOWN
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State | OH
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Zip | 44514-3542
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Country | US
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Telephone | 330-629-2919
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Fax | 330-629-2915
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Provider Business Mailing Address
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Address Line | 1156 W WESTERN RESERVE RD
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City | YOUNGSTOWN
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State | OH
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Zip | 44514-3542
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Country | US
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Telephone | 330-629-2919
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Fax | 330-629-2915
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Authorized Official
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Title or Position | C.E.O.
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Name | CARLA CLARK
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Credential |
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Telephone | 330-207-7355
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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 |
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