Organization
PERSONACARE OF OHIO, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARILYN A. WEAVER (ASSISTANT SECRETARY)
(502) 596-7563
Entity
Organization
Contact information
Practice address
70 NORMANDY DR, PAINESVILLE, OH 44077-1616
(440) 357-1311
(440) 357-1299
Mailing address
680 S 4TH ST, LOUISVILLE, KY 40202-2407
(502) 596-7301
(502) 596-4134
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
5868
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000157426
ANTHEM
OH
05
—
07-00754
—
OH
01
—
341708824-00
WORKMAN'S COMPENSATION
OH
Enumeration date
11/01/2006
Last updated
10/19/2017
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