Organization
ST LEONARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SYLVIA CLASEN (CONTROLLER)
(937) 439-7159
Entity
Organization
Contact information
Practice address
8100 CLYO RD, CENTERVILLE, OH 45458-2720
(937) 436-6317
(937) 439-7104
Mailing address
8100 CLYO RD, CENTERVILLE, OH 45458-2720
(937) 436-6317
(937) 439-7104
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
1887
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2218602
—
OH
Enumeration date
09/22/2005
Last updated
08/22/2020
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