Organization
GOOD SHEPHERD HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER P WIDMAN (ADMINISTRATOR)
(419) 937-1801
Entity
Organization
Contact information
Practice address
725 COLUMBUS AVE, FOSTORIA, OH 44830-3255
(419) 435-1801
(419) 435-1594
Mailing address
725 COLUMBUS AVE, FOSTORIA, OH 44830-3255
(419) 435-1801
(419) 435-1594
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0982N
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3293921
—
OH
Enumeration date
09/02/2006
Last updated
06/12/2019
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