Organization
VANCREST ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK S MCCLEERY (CFO)
(419) 238-0715
Entity
Organization
Contact information
Practice address
1600 PARK AVE, EATON, OH 45320-9674
(937) 456-3010
Mailing address
120 W MAIN ST STE 200, VAN WERT, OH 45891-1761
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2781100
—
OH
Enumeration date
12/04/2020
Last updated
12/04/2020
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