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NPI Code Detail

MEDICARE: EVANGELICAL RETIREMENT VILLAGES,INC. OF DAYTON DBA FRIENDSHIP VILLAGE

MEDICARE: EVANGELICAL RETIREMENT VILLAGES,INC. OF DAYTON DBA FRIENDSHIP VILLAGE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility2380OH

General Provider Information

NPI Number : 1245235845
Entity Type Code : Organization
Provider Name (Legal Business Name) : EVANGELICAL RETIREMENT VILLAGES,INC. OF DAYTON DBA FRIENDSHIP VILLAGE
Provider Business Mailing Address
First Line : 5790 DENLINGER RD
Second Line :
City : DAYTON
State : OH
Zip : 45426-1838
Country : US
Telephone Number : 937-838-5581
Fax Number : 937-854-8203
Provider Business Practice Location Address
First Line : 5790 DENLINGER RD
Second Line :
City : DAYTON
State : OH
Zip : 45426-1838
Country : US
Telephone Number : 937-838-5581
Fax Number : 937-854-8203
Authorized Official
Title or Position : PRESIDENT
Name : MR. PETER D CRANE
Credential :
Telephone Number : 937-837-5581
Provider Enumeration Date : 06/20/2005
Last Update Date : 08/22/2020

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1790948966 — ROBYN MARIE TITLEY SLP
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1225294119 — VERA WORTHAM PTA
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1629228119 — MR. BRANDEN KELLERY BEASON MS, OTR/L
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Directions to “EVANGELICAL RETIREMENT VILLAGES,INC. OF DAYTON DBA FRIENDSHIP VILLAGE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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