Organization
MOTHER ANGELINE MCCRORY MANOR, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNA R FAWLEY (ADMINISTRATOR)
(614) 751-5700
Entity
Organization
Contact information
Practice address
5199 E BROAD ST, COLUMBUS, OH 43213-3800
(614) 751-5700
(614) 751-8311
Mailing address
5199 E BROAD ST, COLUMBUS, OH 43213-3800
(614) 751-5700
(614) 751-8311
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2422N
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2542636
—
OH
Enumeration date
12/21/2006
Last updated
09/10/2024
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