Organization
FLINT RIDGE VILLAGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDALL E KELLER (MANAGER / CO-OWNER)
(740) 344-0388
Entity
Organization
Contact information
Practice address
65 MCMILLEN DR, NEWARK, OH 43055-3648
(740) 344-0388
(740) 344-0345
Mailing address
65 MCMILLEN DR, NEWARK, OH 43055-3648
(740) 344-0388
(740) 344-0345
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
253Z00000X
OH
Other
Enumeration date
03/09/2009
Last updated
03/09/2009
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