Provider Demographics
NPI:1235244864
Name:DEARTH MANAGEMENT, INC
Entity Type:Organization
Organization Name:DEARTH MANAGEMENT, INC
Other - Org Name:MORNING VIEW CARE CENTER OF CENTERBURG
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:PO BOX 610
Mailing Address - Street 2:
Mailing Address - City:CENTERBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43011-0610
Mailing Address - Country:US
Mailing Address - Phone:740-625-5401
Mailing Address - Fax:740-625-5367
Practice Address - Street 1:4531 COLUMBUS RD
Practice Address - Street 2:
Practice Address - City:CENTERBURG
Practice Address - State:OH
Practice Address - Zip Code:43011-9401
Practice Address - Country:US
Practice Address - Phone:740-625-5401
Practice Address - Fax:740-625-5367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1036314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0398574Medicaid
OH0398574Medicaid