Organization
COVENANT CARE OHIO, INC
Active
Other names
Villa Georgetown
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL A SPARKS (DIRECTOR OT REIMBURSEMENT)
(949) 349-1200
Entity
Organization
Contact information
Practice address
8065 DR FAUL RD, GEORGETOWN, OH 45121-8811
(937) 378-4178
(937) 378-3107
Mailing address
8065 DR FAUL RD, GEORGETOWN, OH 45121-8811
(937) 378-4178
(937) 378-3107
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
5494
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2056340
—
OH
Enumeration date
10/07/2005
Last updated
10/28/2008
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