Provider Demographics
NPI:1497752828
Name:OHIO VALLEY MANOR, INC.
Entity Type:Organization
Organization Name:OHIO VALLEY MANOR, INC.
Other - Org Name:ADVANCED REGIONAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:R
Authorized Official - Last Name:GESCHWIND
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:937-392-4318
Mailing Address - Street 1:5280 RTS 62-68
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:45167
Mailing Address - Country:US
Mailing Address - Phone:937-392-4318
Mailing Address - Fax:937-392-4568
Practice Address - Street 1:5280 RTS 62-68
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:OH
Practice Address - Zip Code:45167
Practice Address - Country:US
Practice Address - Phone:937-392-4318
Practice Address - Fax:937-392-4568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1990314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2253154Medicaid
OH366712Medicare ID - Type Unspecified