Organization
COVENANT VILLAGE OF GREEN TOWNSHIP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY MILLER (VICE PRESIDENT)
(513) 605-2701
Entity
Organization
Contact information
Practice address
3210 W FORK RD, CINCINNATI, OH 45211-1948
(513) 605-2700
Mailing address
12500 REED HARTMAN HWY, SUITE 200, CINCINNATI, OH 45241-1892
(513) 605-2700
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2616N
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0073645
—
OH
Enumeration date
06/15/2012
Last updated
05/31/2022
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