Provider Demographics
NPI:1164520805
Name:ASHTABULA COUNTY NURSING AND REHAB CENTER
Entity Type:Organization
Organization Name:ASHTABULA COUNTY NURSING AND REHAB CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:SEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-224-2161
Mailing Address - Street 1:5740 DIBBLE RD
Mailing Address - Street 2:
Mailing Address - City:KINGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44048-9809
Mailing Address - Country:US
Mailing Address - Phone:440-224-2161
Mailing Address - Fax:
Practice Address - Street 1:5740 DIBBLE RD
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44048-9809
Practice Address - Country:US
Practice Address - Phone:440-224-2161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1221510001Medicare NSC