Organization
VANCREST OF ADA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK S MCCLEERY (CFO)
(419) 238-0715
Entity
Organization
Contact information
Practice address
600 W NORTH AVE, ADA, OH 45810-1041
(419) 238-0715
(419) 238-4814
Mailing address
120 W MAIN ST, SUITE 200, VAN WERT, OH 45891-1761
(419) 238-0715
(419) 238-4814
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
OH
Other
Enumeration date
02/10/2016
Last updated
02/10/2016
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