Organization
OTTERBEIN CRIDERSVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RITA C HAWKINS (AVP FINANCE/CONTROLLER)
(513) 933-5401
Entity
Organization
Contact information
Practice address
100 RED OAK DR, CRIDERSVILLE, OH 45806-9618
(419) 645-5114
(419) 645-7115
Mailing address
100 RED OAK DR, CRIDERSVILLE, OH 45806-9618
(419) 645-5114
(419) 645-7115
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1959N
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0228088
—
OH
01
—
4488240001
DMERC
—
Enumeration date
08/22/2005
Last updated
01/05/2015
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