Shane Hill Divine Opco LLC

NPI #1710775523 in Rockford, Ohio

Provider Information

NPI Number
1710775523
Entity Type
Organization
Organization Name
Shane Hill Divine Opco LLC
Primary Specialty
Skilled Nursing Facility
Enumeration Date
Apr 30, 2025
Last Updated
Apr 30, 2025

Practice Location

Address
10731 STATE ROUTE 118
State
Ohio
ZIP Code
45882-8947
Phone
(330) 620-7828

Authorized Official

Name
JEFFREY DEGYANSKY
Title
CHIEF OPERATING OFFICER
Phone
(330) 620-7828

Specialties & Taxonomy Codes

Specialty
Skilled Nursing Facility

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