MEDICARE: HARTVILLE HOMES INC

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
1	315P00000X	Intellectual Disabilities Intermediate Care Facility	1610046	OH

General Provider Information

NPI Number	:	1578711404
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARTVILLE HOMES INC

Provider Business Mailing Address
First Line	:	7237A WHIPPLE AVE NW
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-7137
Country	:	US
Telephone Number	:	330-244-0050
Fax Number	:

Provider Business Practice Location Address
First Line	:	22000 ORCHARD ST
Second Line	:
City	:	WEST LAFAYETTE
State	:	OH
Zip	:	43845-9613
Country	:	US
Telephone Number	:	740-545-6366
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	MICHAEL D SLEUTZ
Credential	:
Telephone Number	:	330-244-0050

Provider Enumeration Date	:	09/04/2008
Last Update Date	:	09/04/2008

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