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Organization

VANCREST OF NEW CARLISLE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KYLE HOLLIDAY (ASST CFO)
(419) 238-0715
Entity
Organization

Contact information

Practice address
1885 N DAYTON LAKEVIEW RD, NEW CARLISLE, OH 45344-8292
(937) 845-8219
(937) 845-2404
Mailing address
120 W MAIN ST STE 200, VAN WERT, OH 45891-1761
(419) 238-0715
(419) 238-4814

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0077576
OH
Enumeration date
12/14/2012
Last updated
05/19/2026
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