Organization
PAVILION CARE CENTER LLC
Active
Other names
The Pavilion
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROL J GROEBER (VICE PRESIDENT/MIS)
(937) 964-8974
Entity
Organization
Contact information
Practice address
705 FULTON ST, SIDNEY, OH 45365-3203
(937) 492-9591
(937) 498-0529
Mailing address
705 FULTON ST, SIDNEY, OH 45365-3203
(937) 492-9591
(937) 498-0529
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2308078
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2308078
—
OH
Enumeration date
02/21/2006
Last updated
07/22/2008
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