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General NPI Number Information
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NPI Number | 1750757589
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Entity Type | Organization
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Legal Business Name | ALPINE HOUSE OF RAVENNA INC
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Dates
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Enumeration Date | 08/17/2015
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Last Update Date | 04/11/2024
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Provider Practice Location Address
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Address Line | 7000 STATE ROUTE 88
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City | RAVENNA
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State | OH
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Zip | 44266-9188
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Country | US
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Telephone | 330-297-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 2402 MISSION HILL DR
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City | PERRYSBURG
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State | OH
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Zip | 43551-6239
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Country | US
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Telephone | 330-297-7000
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. JOSEPH K WELLS
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Credential | OTD, OTR/L
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Telephone | 419-472-5350
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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 | 2705R
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License Number State | OH
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