Provider Demographics
NPI:1043297369
Name:HEALTHCARE VENTURES OF OHIO
Entity type:Organization
Organization Name:HEALTHCARE VENTURES OF OHIO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:IRELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-523-4370
Mailing Address - Street 1:1925 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:OH
Mailing Address - Zip Code:45875-1540
Mailing Address - Country:US
Mailing Address - Phone:419-523-4370
Mailing Address - Fax:419-523-3591
Practice Address - Street 1:1925 E 4TH ST
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:OH
Practice Address - Zip Code:45875-1540
Practice Address - Country:US
Practice Address - Phone:419-523-4370
Practice Address - Fax:419-523-3591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1543N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2561357Medicaid
OH2561357Medicaid