204 W. Main Street Operating Company, LLC
Skilled Nursing Facility in New London, OH. Organization (NPI-2).
NPI number1457463556
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1457463556
- Entity type
- Organization (NPI-2)
- Legal business name
- 204 W. Main Street Operating Company, LLC
- Organization subpart
- No
- Enumeration date
- Aug 31, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | – | – | Yes |
Other names
- New London Health Care Center (Doing Business As)
Practice location
204 W Main StNew London, OH 44851-1070
Phone 419-929-1563
Mailing address
204 W Main StNew London, OH 44851-1070
Authorized official
Kevin P Breslin
Executive Vice President - Cfo
2012424000
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