Provider Demographics
NPI:1225270556
Name:FIDLAY RETIREMENT, LLC
Entity Type:Organization
Organization Name:FIDLAY RETIREMENT, LLC
Other - Org Name:PRIMROSE RETIREMENT COMMUNITY OF FINDLAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MS
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:605-226-3300
Mailing Address - Street 1:8580 TOWNSHIP ROAD
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840
Mailing Address - Country:US
Mailing Address - Phone:419-422-6200
Mailing Address - Fax:419-422-6230
Practice Address - Street 1:8580 TOWNSHIP ROAD 237
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840
Practice Address - Country:US
Practice Address - Phone:419-422-6200
Practice Address - Fax:419-422-6230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2483R310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility