Organization
925 WAGNER OPERATING LLC
Active
Other names
Village Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THEODORE M DUAY III C.P.A. (CHIEF FINANCIAL OFFICER)
(786) 888-3310
Entity
Organization
Contact information
Practice address
925 WAGNER AVE, GALION, OH 44833-1535
(419) 468-1090
Mailing address
1055 NE 125TH ST, NORTH MIAMI, FL 33161-5804
(786) 888-3310
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2813629
—
OH
Enumeration date
01/23/2008
Last updated
12/02/2009
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