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General NPI Number Information
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NPI Number | 1508235128
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Entity Type | Organization
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Legal Business Name | BRETHREN CARE VILLAGE, LLC
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Dates
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Enumeration Date | 09/24/2015
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Last Update Date | 04/25/2024
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Provider Practice Location Address
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Address Line | 2000 CENTER ST
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City | ASHLAND
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State | OH
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Zip | 44805-4325
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Country | US
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Telephone | 419-289-1585
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Fax |
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Provider Business Mailing Address
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Address Line | 2140 CENTER ST
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City | ASHLAND
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State | OH
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Zip | 44805-4376
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Country | US
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Telephone | 419-289-1585
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MINDY SCURLOCK
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Credential |
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Telephone | 419-289-1585
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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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