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Organization

ST. LUKE LUTHERAN COMMUNITY-MINERVA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RONALD E DERRY (CFO)
(330) 966-5619
Entity
Organization

Contact information

Practice address
4301 WOODALE AVE SE, MINERVA, OH 44657-8923
(330) 499-8341
(330) 497-6141
Mailing address
220 APPLEGROVE ST NE, NORTH CANTON, OH 44720-1610
(330) 499-8341
(330) 497-6141

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary

Other

Enumeration date
03/01/2012
Last updated
03/01/2012
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