Organization
FOSTORIA SNF OPCO LLC
Active
Other names
The Independence House of Fostoria
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS DESTEFANE (PRESIDENT)
(314) 543-3800
Entity
Organization
Contact information
Practice address
1000 INDEPENDENCE AVE, FOSTORIA, OH 44830-9614
(419) 435-8505
Mailing address
1869 CRAIG PARK CT, SAINT LOUIS, MO 63146-4122
(314) 543-3800
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
11/04/2025
Last updated
11/04/2025
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