Organization
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Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PHYLLIS ANN COPLEY (ADM OWNER)
(740) 867-4160
Entity
Organization
Contact information
Practice address
304 3RD AVE, CHESAPEAKE, OH 45619
(740) 867-4160
(740) 867-4162
Mailing address
304 3RD AVE, CHESAPEAKE, OH 45619
(740) 867-4160
(740) 867-4162
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
05/04/2007
Last updated
08/22/2020
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