Organization
CT OHIO BELLBROOK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAFAEL A MOERMAN (MANAGER)
(516) 865-1500
Entity
Organization
Contact information
Practice address
1957 N LAKEMAN DR, BELLBROOK, OH 45305-1245
(937) 848-7800
(937) 848-5683
Mailing address
1957 N LAKEMAN DR, BELLBROOK, OH 45305-1245
(937) 848-7800
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141348
—
OH
Enumeration date
04/17/2018
Last updated
04/15/2025
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