Provider Demographics
NPI:1235244856
Name:MORROW CARE, INC
Entity Type:Organization
Organization Name:MORROW CARE, INC
Other - Org Name:BENNINGTON GLEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHEPHERD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-847-1070
Mailing Address - Street 1:825 STATE ROUTE 61
Mailing Address - Street 2:
Mailing Address - City:MARENGO
Mailing Address - State:OH
Mailing Address - Zip Code:43334-9215
Mailing Address - Country:US
Mailing Address - Phone:419-253-0144
Mailing Address - Fax:419-253-0146
Practice Address - Street 1:825 STATE ROUTE 61
Practice Address - Street 2:
Practice Address - City:MARENGO
Practice Address - State:OH
Practice Address - Zip Code:43334-9215
Practice Address - Country:US
Practice Address - Phone:419-253-0144
Practice Address - Fax:419-253-0146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2258314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2161539Medicaid
366194Medicare ID - Type Unspecified