Organization
RESTHAVEN OPERATIONS LLC
Active
Parent organization
REST HAVEN NURSING HOME INC
Other names
Rest Haven Nursing Home Vancrest of Greenville
Organization subpart
Yes
Provider details
NPI number
Legal business name
REST HAVEN NURSING HOME INC
Authorized official
MR. MARK STUART MCCLEERY CPA (CFO SHAREHOLDER)
(419) 238-0715
Entity
Organization
Contact information
Practice address
1096 NORTH OHIO STREET, GREENVILLE, OH 45331
(937) 548-1138
Mailing address
1096 NORTH OHIO STREET, GREENVILLE, OH 45331
(937) 548-1138
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1467
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000002692
ANTHEM BCBS
OH
05
—
2472622
—
OH
Enumeration date
10/20/2006
Last updated
05/08/2008
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