Organization
GOOD SHEPHERD HOME
Active
Parent organization
0982N
Other names
Good Shepherd Home Assisted Living
Organization subpart
Yes
Provider details
NPI number
Legal business name
0982N
Authorized official
CHRISTOPHER P WIDMAN (EXECUTIVE DIRECTOR)
(419) 937-1801
Entity
Organization
Contact information
Practice address
725 COLUMBUS AVE, FOSTORIA, OH 44830-3255
(419) 937-1801
(419) 937-1800
Mailing address
725 COLUMBUS AVE, FOSTORIA, OH 44830-3255
(419) 937-1801
(419) 937-1800
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3293921
—
OH
Enumeration date
06/12/2019
Last updated
06/12/2019
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