Organization
MANOR HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELAINE PHILLIPS LPN (ADMINISTRATOR)
(419) 258-1312
Entity
Organization
Contact information
Practice address
204 ARCHER DR, ANTWERP, OH 45813
(419) 258-1500
(419) 258-1509
Mailing address
PO BOX 759, ANTWERP, OH 45813-0759
(419) 258-1500
(419) 258-1509
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
2449R
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164327447
—
OH
Enumeration date
12/03/2010
Last updated
12/13/2010
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