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General NPI Number Information
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NPI Number | 1760084115
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Entity Type | Organization
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Legal Business Name | UNITED CHURCH HOMES INC
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Dates
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Enumeration Date | 11/11/2020
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Last Update Date | 01/14/2021
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Provider Practice Location Address
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Address Line | 200 TIMBERLINE DR
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City | MARIETTA
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State | OH
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Zip | 45750-9238
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Country | US
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Telephone | 740-376-0535
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Fax | 740-376-0153
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Provider Business Mailing Address
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Address Line | PO BOX 1806
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City | MARION
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State | OH
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Zip | 43301-1806
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Country | US
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Telephone | 740-382-4885
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Fax | 740-382-4884
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Authorized Official
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Title or Position | VICE PRESIDENT OF FINANCIAL SERVICE
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Name | MR. RICHARD D DIBLE
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Credential |
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Telephone | 740-223-2022
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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 |
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License Number State |
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