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Organization
FOUNTAIN PARK RIESEN CENTER
Active
Organization
FOUNTAIN PARK RIESEN CENTER
Active
Parent organization
FOUNTAIN PARK INN& VILLAS, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
FOUNTAIN PARK INN& VILLAS, LLC
Authorized official
SHEILA LYNN SABO (OWNER)
(941) 270-7627
Entity
Organization
Contact information
Practice address
1433 N MAIN ST, BRYAN, OH 43506-1053
(419) 633-9191
(419) 633-9192
Mailing address
1391 N MAIN ST, BRYAN, OH 43506-1057
(419) 633-4315
(419) 636-7287
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
2489R
OH
Other
Enumeration date
01/14/2009
Last updated
01/14/2009
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