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Organization

HERITAGE PARK NURSING AND REHABILITATION CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TIMOTHY WOODROW SHACKLEFORD NHA (ADMINISTRATOR)
(330) 264-2446
Entity
Organization

Contact information

Practice address
3071 N ELYRIA RD, WOOSTER, OH 44691-9379
(330) 264-2446
(330) 264-5770
Mailing address
3071 N ELYRIA RD, WOOSTER, OH 44691-9379
(330) 264-2446
(330) 264-5770

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
5756
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2146770
OH
Enumeration date
02/17/2006
Last updated
08/22/2020
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