Organization
DIVERSICARE OF MANSFIELD, LLC
Active
Parent organization
DIVERSICARE LEASING COMPANY II, LLC
Other names
Ontario Pointe
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIVERSICARE LEASING COMPANY II, LLC
Authorized official
KELLY J GILL (PRESIDENT AND CEO)
(615) 771-7575
Entity
Organization
Contact information
Practice address
2124 PARK AVE W, ONTARIO, OH 44906-3807
(419) 529-6447
(419) 529-2108
Mailing address
2124 PARK AVE W, ONTARIO, OH 44906-3807
(419) 529-6447
(419) 529-2108
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
07/12/2014
Last updated
07/12/2014
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