Organization
LIBERTY/MATRIX OF OXFORD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA M BLACK-KUREK (PRESIDENT)
(937) 296-1550
Entity
Organization
Contact information
Practice address
7445 LIBERTY WOODS LN, DAYTON, OH 45459-3911
(937) 296-1550
(937) 296-1540
Mailing address
6099 FAIRFIELD RD, OXFORD, OH 45056-1507
(513) 523-6353
(513) 523-1183
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
OH00725
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2559913
—
OH
Enumeration date
06/10/2006
Last updated
08/22/2020
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