Organization
EXTENDICARE HOMES, INC.
Active
Other names
Ridgewood Nursing & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA JO MAASSEN (DIRECTOR OF COMPLIANCE)
(414) 908-8119
Entity
Organization
Contact information
Practice address
1600 SAINT PARIS PIKE, SPRINGFIELD, OH 45504-1226
(937) 399-8131
(937) 399-8343
Mailing address
111 W MICHIGAN ST, MILWAUKEE, WI 53203-2903
(414) 908-8119
(414) 908-7105
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2347053
—
OH
Enumeration date
11/17/2006
Last updated
03/30/2008
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