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General NPI Number Information
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NPI Number | 1558420828
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Entity Type | Organization
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Legal Business Name | JACKSON COUNTY HEALTH FACILITIES INC.
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 09/16/2009
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Provider Practice Location Address
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Address Line | 142 JENKINS MEMORIAL RD
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City | WELLSTON
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State | OH
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Zip | 45692-9561
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Country | US
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Telephone | 740-384-2119
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Fax |
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Provider Business Mailing Address
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Address Line | 142 JENKINS MEMORIAL RD
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City | WELLSTON
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State | OH
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Zip | 45692-9561
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. DAVID NICHOLS
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Credential |
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Telephone | 740-384-2119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 1479R
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 1479N
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License Number State | OH
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