Organization
VANCREST OF URBANA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON D. BAGLEY (VICE PRESIDENT)
(419) 238-0715
Entity
Organization
Contact information
Practice address
2380 S US HIGHWAY 68, URBANA, OH 43078-9470
(937) 653-5291
(937) 653-3885
Mailing address
120 W MAIN ST, SUITE 200, VAN WERT, OH 45891-1761
(419) 238-0715
(419) 238-4814
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2900687
—
OH
Enumeration date
03/18/2008
Last updated
09/04/2008
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