Organization
TAEJ RESIDENTIAL CARE, LLC
Active
Other names
Diamond View RCF
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL F JEDRA LNHA (ADMINISTRATOR)
(419) 522-4450
Entity
Organization
Contact information
Practice address
111 S DIAMOND ST, MANSFIELD, OH 44902-7510
(419) 522-4450
(419) 522-4552
Mailing address
111 S DIAMOND ST, MANSFIELD, OH 44902-7510
(419) 522-4450
(419) 522-4552
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
1457R
OH
Other
Enumeration date
12/11/2007
Last updated
12/11/2007
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