Provider Demographics
NPI:1346908035
Name:TOLEDO HEALTHCARE AND REHABILITATION CENTER LLC
Entity Type:Organization
Organization Name:TOLEDO HEALTHCARE AND REHABILITATION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:DIPASQUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-720-0406
Mailing Address - Street 1:555 ANTHONY WAYNE TRL
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43566-1516
Mailing Address - Country:US
Mailing Address - Phone:330-720-0406
Mailing Address - Fax:
Practice Address - Street 1:6101 N SUMMIT ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43611-1242
Practice Address - Country:US
Practice Address - Phone:419-727-7870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2051NOtherLICENSURE