Organization
SPRINGFIELD HEALTH CARE OPERATING COMPANY, LLC
Active
Other names
Springfield Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS E. BARTLEBAUGH (CO-MANAGING MEMBER)
(330) 425-4696
Entity
Organization
Contact information
Practice address
404 E. MCCREIGHT AVE., SPRINGFIELD, OH 45503
(937) 399-8311
(937) 399-7370
Mailing address
2457 BROADWAY AVENUE, OAKWOOD VILLAGE, OH 44146
(440) 439-7976
(440) 232-7113
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
1044N
OH
314000000X
Skilled Nursing Facility
Primary
1044N
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0391204
—
OH
Enumeration date
11/01/2006
Last updated
04/28/2009
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