Organization
GARDEN MANOR EXTENDED CARE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHLEEN HAMMON (V.P. MARKETING)
(513) 699-4651
Entity
Organization
Contact information
Practice address
6898 HAMILTON MIDDLETOWN ROAD, MIDDLETOWN, OH 45044-7859
(513) 424-5321
(513) 420-5367
Mailing address
6898 HAMILTON MIDDLETOWN RD, MIDDLETOWN, OH 45044-7859
(513) 424-5321
(513) 420-5367
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
0987R
OH
314000000X
Skilled Nursing Facility
2171
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000002966
ANTHEM BCBS
OH
05
—
306753
—
OH
Enumeration date
11/03/2005
Last updated
12/14/2010
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