Provider Demographics
NPI:1093378879
Name:MH SIDNEY OPERATING, LLC
Entity Type:Organization
Organization Name:MH SIDNEY OPERATING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REIMBURSEMENT ANALYST
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-956-0252
Mailing Address - Street 1:1150 W RUSSELL RD
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365-7025
Mailing Address - Country:US
Mailing Address - Phone:937-498-1818
Mailing Address - Fax:937-592-2975
Practice Address - Street 1:1150 W RUSSELL RD
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365-7025
Practice Address - Country:US
Practice Address - Phone:937-498-1818
Practice Address - Fax:937-592-2975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-17
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility