Organization
OAK HAVEN RESIDENTIAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHERRY KAYE WEBB LPN (ADMINISTRATOR)
(419) 615-3357
Entity
Organization
Contact information
Practice address
152 MAIN ST, CLOVERDALE, OH 45827-9778
(419) 488-2310
(419) 488-2321
Mailing address
PO BOX 86, CLOVERDALE, OH 45827-0086
(419) 488-2310
(419) 488-2321
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0109295
—
OH
Enumeration date
12/08/2020
Last updated
12/08/2020
Update your record
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