Organization
THE SARAH JANE LIVING CENTER LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK STUART MCCLEERY CPA (CFO)
(419) 238-0715
Entity
Organization
Contact information
Practice address
328 WEST SECOND STREET, DELPHOS, OH 45833
(419) 692-6618
(419) 692-2654
Mailing address
120 W MAIN ST, SUITE 200, VAN WERT, OH 45891-1761
(419) 238-0715
(419) 238-4814
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
5862
OH
314000000X
Skilled Nursing Facility
Primary
2296N
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2184792
—
OH
Enumeration date
10/11/2006
Last updated
12/05/2016
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