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Wickshire Fairborn Opco LLC

Assisted Living Facility in Fairborn, OH. Organization (NPI-2).

NPI number1982243382
StatusActive
Last updated in NPPESJan 2, 2020

Details

NPI
1982243382
Entity type
Organization (NPI-2)
Legal business name
Wickshire Fairborn Opco LLC
Organization subpart
No
Enumeration date
Jan 2, 2020
Certification date
Jan 2, 2020
Last updated
Jan 2, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
310400000X Assisted Living Facility––Yes

Practice location

2270 Park Hills Drive
Fairborn, OH 45324

Phone 937-343-6208 · Fax 937-754-9830

Mailing address

750 Old Hickory Blvd
Building One Suite 125
Brentwood, TN 37027

Phone 615-942-0240

Authorized official

Daniel Okeefe
Ceo
6159420240

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