Organization
VANCREST OF NEW CARLISLE
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
310400000X
Assisted Living Facility
Primary
2553R
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0087603
—
OH
Enumeration date
12/10/2012
Last updated
05/19/2026
Update your record
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