Organization
DEACONESS LONG TERM CARE OF OHIO, INC.
Active
Other names
Convoy Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA BROOKS (CFO)
(513) 487-3600
Entity
Organization
Contact information
Practice address
127 MENTZER DR, CONVOY, OH 45832
(419) 749-2194
(419) 749-2424
Mailing address
440 LAFAYETTE AVE, STE 400, CINCINNATI, OH 45220-1022
(513) 487-3600
(513) 487-3653
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1767N
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0214771
—
OH
Enumeration date
08/26/2005
Last updated
08/22/2020
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