Organization
PEREGRINE SERVICES OF CANTON, LLC
Active
Other names
Summit'sTrace of Canton
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL M DAUERMAN (CEO)
(614) 459-2656
Entity
Organization
Contact information
Practice address
836 34TH ST NW, CANTON, OH 44709-2947
(614) 459-2482
(614) 459-2641
Mailing address
1661 OLD HENDERSON RD, COLUMBUS, OH 43220-3644
(614) 459-2656
(614) 459-2641
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2771095
—
OH
Enumeration date
09/17/2007
Last updated
11/08/2007
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