Organization Name: | CROGHAN ADULT CARE FACILITY LLC |
NPI Number: | 1467841973 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AMY E KEPLER (OWNER) |
Mailing Address: | 9837 Main Street Croghan |
State: | NY US |
Postal Code: | 13327 |
Phone Number: | 3154088973 |
Fax Number: | |
NPI Enumeration Date: | 01/21/2015 |
NPI Last Update Date: | 01/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385H00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | |
Taxonomy Definition: |