Provider Demographics
NPI:1144202417
Name:MARIETTA AREA HEALTH INC
Entity Type:Organization
Organization Name:MARIETTA AREA HEALTH INC
Other - Org Name:HARMAR PLACE REHABILITATION AND EXTENDED CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:BOULTON
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:740-376-5600
Mailing Address - Street 1:401 HARMAR ST
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-2732
Mailing Address - Country:US
Mailing Address - Phone:740-376-5600
Mailing Address - Fax:740-376-5623
Practice Address - Street 1:401 HARMAR ST
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-2732
Practice Address - Country:US
Practice Address - Phone:740-376-5600
Practice Address - Fax:740-376-5623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4961313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Not Answered314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1489134Medicaid
OH1489134Medicaid