Organization
PAVILION AT PIKETON FOR NURSING AND REHABILITATION LLC
Active
Other names
The Pavilion at Piketon
Organization subpart
No
Provider details
NPI number
Authorized official
RAFAEL A MOERMAN (MANAGING MEMBER)
(848) 299-3662
Entity
Organization
Contact information
Practice address
7143 US HIGHWAY 23, PIKETON, OH 45661-9527
(740) 289-2394
(740) 289-2231
Mailing address
1 VALLEY GREENS DR, VALLEY STREAM, NY 11581-3634
(848) 299-3662
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
1621N
OH
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
03/28/2018
Last updated
07/10/2019
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