# PLYMOUTH NH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Plymouth Nursing and Rehab
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467457044
- **Authorized official:** WILLIAM MANDO (CFO)
- **Authorized official phone:** (813) 635-9500

## Contact information

- **Practice address:** 309 N KINGSTON RD, PLYMOUTH, IN 46563-1927
- **Practice address phone:** (574) 936-9025
- **Practice address fax:** (574) 936-4928
- **Mailing address:** 309 N KINGSTON RD, PLYMOUTH, IN 46563-1927
- **Mailing address phone:** (574) 936-9025
- **Mailing address fax:** (574) 936-4928

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | IN | Yes |

## Other

- **Enumeration date:** 06/20/2005
- **Last updated:** 08/22/2020