Organization
WAYSIDE FARM INC.
Active
Other names
Wayside Farm Nursing and Rehab Center
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW W POOL (PRESIDENT)
(330) 923-7828
Entity
Organization
Contact information
Practice address
4557 QUICK RD, PENINSULA, OH 44264-9708
(330) 923-7828
(330) 923-1201
Mailing address
4557 QUICK RD, PENINSULA, OH 44264-9794
(330) 923-7828
(330) 923-1201
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
1279
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0040879
—
OH
Enumeration date
07/10/2006
Last updated
05/29/2026
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