Organization Name: | FULTON MANOR NURSING & REHABILITATION CENTER |
NPI Number: | 1265427892 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID RENTON (ADMINISTRATOR) |
Mailing Address: | 723 S Shoop Ave Wauseon |
State: | OH US |
Postal Code: | 435671722 |
Phone Number: | 4193352017 |
Fax Number: | |
NPI Enumeration Date: | 09/20/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 3140N1450X |
License Number: | 5186 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Skilled Nursing Facility |
Taxonomy Specialization: | Nursing Care, Pediatric |
Taxonomy Definition: | A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment. |