Organization
PROVIDENCE CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DENICE DAY LNHA (ADMINISTRATOR)
(419) 627-2273
Entity
Organization
Contact information
Practice address
2025 HAYES AVE, SANDUSKY, OH 44870-4739
(419) 627-2273
(419) 627-5588
Mailing address
2025 HAYES AVE, SANDUSKY, OH 44870-4739
(419) 627-2273
(419) 627-5588
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
4460
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000312181
ANTHEM PROVIDER NUMBER
OH
05
—
0860064
—
OH
Enumeration date
11/17/2005
Last updated
01/17/2008
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