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Organization

OTTERBEIN PORTAGE VALLEY, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. RITA C HAWKINS (AVP FINANCE/CONTROLLER)
(513) 933-5401
Entity
Organization

Contact information

Practice address
20311 PEMBERVILLE RD, PEMBERVILLE, OH 43450-9413
(419) 833-7000
(419) 833-5763
Mailing address
20311 PEMBERVILLE RD, PEMBERVILLE, OH 43450-9413
(419) 833-7000
(419) 833-5763

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
4762
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0537130002
DMERC
05
0610093
OH
Enumeration date
08/22/2005
Last updated
04/24/2017
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