Provider Demographics
NPI:1306849278
Name:MEDCENTRAL HOMECARE AND HOSPICE
Entity Type:Organization
Organization Name:MEDCENTRAL HOMECARE AND HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARTE
Authorized Official - Middle Name:D
Authorized Official - Last Name:ALSLEBEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, JD
Authorized Official - Phone:419-526-8442
Mailing Address - Street 1:335 GLESSNER AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44903-2269
Mailing Address - Country:US
Mailing Address - Phone:419-526-8442
Mailing Address - Fax:419-756-2298
Practice Address - Street 1:1020 CRICKET LN
Practice Address - Street 2:LOWR LEVEL
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-4104
Practice Address - Country:US
Practice Address - Phone:419-526-8442
Practice Address - Fax:419-756-2298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH367277Medicare ID - Type UnspecifiedHOMECARE