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General NPI Number Information
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NPI Number | 1891387106
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Entity Type | Organization
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Legal Business Name | CHS - PATASKALA, INC
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Dates
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Enumeration Date | 02/08/2021
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Last Update Date | 02/08/2021
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Provider Practice Location Address
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Address Line | 383 W COSHOCTON ST
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City | JOHNSTOWN
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State | OH
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Zip | 43031-1112
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Country | US
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Telephone | 614-359-2385
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Fax | 614-681-0522
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Provider Business Mailing Address
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Address Line | 25000 COUNTRY CLUB BLVD STE 255
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City | NORTH OLMSTED
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State | OH
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Zip | 44070-5337
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Country | US
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Telephone | 440-614-0160
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Fax | 440-614-0168
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANIEL PARKER
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Credential |
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Telephone | 330-554-6619
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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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