Organization
SUPREME COUNCIL OF THE HOUSE OF JACOB OF THE USA INC
Active
Other names
Jacob's Dwelling Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
HULDAH M. CHESNUT NHA (ADMINISTRATOR)
(740) 824-3635
Entity
Organization
Contact information
Practice address
25680 TOWNSHIP RD. 39, COSHOCTON, OH 43812-9195
(740) 824-3635
(740) 824-5205
Mailing address
25680 TOWNSHIP RD. 39, COSHOCTON, OH 43812-9195
(740) 824-3635
(740) 824-5205
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2436
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0280619
—
OH
Enumeration date
11/06/2006
Last updated
07/23/2009
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