Organization
SHEPHERD OF THE VALLEY LUTHERAN RETIREMENT SERVICES, INC.
Active
Other names
Shepherd of the Valley - Liberty
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA BROWN (CFO)
(330) 530-4038
Entity
Organization
Contact information
Practice address
1501 TIBBETTS WICK RD, GIRARD, OH 44420-1206
(330) 544-0771
Mailing address
5525 SILICA ROAD, AUSTINTOWN, OH 44515-1002
(330) 530-4038
(330) 530-4039
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0401083
—
OH
Enumeration date
10/02/2006
Last updated
08/28/2020
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