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General NPI Number Information
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NPI Number | 1982780680
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Entity Type | Organization
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Legal Business Name | WOODLAND COUNTRY MANOR INC
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 07/05/2022
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Provider Practice Location Address
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Address Line | 4166 SOMERVILLE RD
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City | SOMERVILLE
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State | OH
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Zip | 45064
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Country | US
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Telephone | 513-523-4449
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Fax | 513-523-7900
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Provider Business Mailing Address
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Address Line | 4166 SOMERVILLE RD
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City | SOMERVILLE
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State | OH
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Zip | 45064
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Country | US
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Telephone | 513-523-4449
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Fax | 513-523-7900
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. LORI A AUER
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Credential |
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Telephone | 513-523-4449
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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 | 4548
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License Number State | OH
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