Provider Demographics
NPI:1073714168
Name:COUNTRY VIEW HAVEN
Entity Type:Organization
Organization Name:COUNTRY VIEW HAVEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:MEISTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-592-8075
Mailing Address - Street 1:P.O. BOX 525
Mailing Address - Street 2:R-858 CO RD 15
Mailing Address - City:NAPOLEON
Mailing Address - State:OH
Mailing Address - Zip Code:43545
Mailing Address - Country:US
Mailing Address - Phone:419-592-8075
Mailing Address - Fax:419-592-6620
Practice Address - Street 1:COUNTRY VIEW HAVEN
Practice Address - Street 2:R858 CO RD 15
Practice Address - City:NAPOLEON
Practice Address - State:OH
Practice Address - Zip Code:43545
Practice Address - Country:US
Practice Address - Phone:419-592-8075
Practice Address - Fax:419-592-6620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility