Organization
OMNI MANOR, INC.
Active
Other names
CHAMPION ESTATES ASSISTED LIVING RESIDENCE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN J MASTERNICK (OWNER/PRESIDENT)
(330) 545-1550
Entity
Organization
Contact information
Practice address
1 WINDSOR PLACE, WARREN, OH 44483
(330) 841-1555
(330) 841-2244
Mailing address
101 W LIBERTY ST, GIRARD, OH 44420-2844
(330) 545-1550
(330) 545-2444
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2619R
DEPARTMENT OF HEALTH
OH
Enumeration date
10/18/2012
Last updated
12/31/2012
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