Provider Demographics
NPI:1144234071
Name:QUANTUM HEALTHCARE, INC.
Entity Type:Organization
Organization Name:QUANTUM HEALTHCARE, INC.
Other - Org Name:MILL MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RANKIN
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:440-967-6617
Mailing Address - Street 1:983 EXCHANGE ST
Mailing Address - Street 2:
Mailing Address - City:VERMILION
Mailing Address - State:OH
Mailing Address - Zip Code:44089-1256
Mailing Address - Country:US
Mailing Address - Phone:440-967-6614
Mailing Address - Fax:440-967-1968
Practice Address - Street 1:983 EXCHANGE ST
Practice Address - Street 2:
Practice Address - City:VERMILION
Practice Address - State:OH
Practice Address - Zip Code:44089-1256
Practice Address - Country:US
Practice Address - Phone:440-967-6614
Practice Address - Fax:440-967-1968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1902N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000385006OtherANTHEM OCCUPATIONAL THERA
000000374807OtherANTHEM SKILLED NURSING
000000385007OtherANTHEM SPEECH THERAPY
OH2510652Medicaid
7551125OtherAETNA
000000385004OtherANTHEM PHYSICAL THERAPY
000000385007OtherANTHEM SPEECH THERAPY
7551125OtherAETNA