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General NPI Number Information
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NPI Number | 1619963980
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Entity Type | Organization
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Legal Business Name | EAST LIVERPOOL CONVALESCENT CENTER, INC
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Dates
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Enumeration Date | 09/22/2005
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Last Update Date | 04/06/2011
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Provider Practice Location Address
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Address Line | 701 ARMSTRONG LN
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City | EAST LIVERPOOL
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State | OH
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Zip | 43920-1284
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Country | US
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Telephone | 330-385-5212
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Fax | 330-385-8566
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Provider Business Mailing Address
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Address Line | 701 ARMSTRONG LN
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City | EAST LIVERPOOL
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State | OH
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Zip | 43920-1284
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Country | US
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Telephone | 330-385-5212
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Fax | 330-385-8566
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MRS. JANICE L. BOWDEN
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Credential | L.N.H.A.
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Telephone | 330-385-3600
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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 | 1542
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License Number State | OH
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