Organization
GENTLEBROOK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANA FISCHER (HOME HEALTH ADMINISTRATOR)
(740) 622-7406
Entity
Organization
Contact information
Practice address
22077 TR 1064, WEST LAFAYETTE, OH 43845
(740) 545-6366
(740) 545-6090
Mailing address
880 SUNNYSIDE ST SW, HARTVILLE, OH 44632-9087
(330) 877-7700
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
03/12/2021
Last updated
03/12/2021
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