Diversicare of Mansfield, LLC

NPI #1073920948 in Ontario, Ohio

Provider Information

NPI Number
1073920948
Entity Type
Organization
Organization Name
Diversicare of Mansfield, LLC
Subpart
Yes (part of a larger organization)
Parent Organization
DIVERSICARE LEASING COMPANY II, LLC
Primary Specialty
Skilled Nursing Facility
Enumeration Date
Jul 12, 2014
Last Updated
Jul 12, 2014

Practice Location

Address
2124 PARK AVE W
State
Ohio
ZIP Code
44906-3807
Phone
(419) 529-6447

Authorized Official

Name
KELLY J GILL
Title
PRESIDENT AND CEO
Phone
(615) 771-7575

Specialties & Taxonomy Codes

Specialty
Skilled Nursing Facility

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