Provider Demographics
NPI:1497202501
Name:RYAN SENIOR CARE
Entity Type:Organization
Organization Name:RYAN SENIOR CARE
Other - Org Name:THE GLENDALE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-389-0800
Mailing Address - Street 1:5020 RYAN RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2065
Mailing Address - Country:US
Mailing Address - Phone:419-389-0800
Mailing Address - Fax:419-389-0819
Practice Address - Street 1:5020 RYAN RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2065
Practice Address - Country:US
Practice Address - Phone:419-389-0800
Practice Address - Fax:419-389-0819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1958R310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility