Provider Demographics
NPI:1508228602
Name:AHF OHIO, INC.
Entity Type:Organization
Organization Name:AHF OHIO, INC.
Other - Org Name:SAMARITAN CARE CENTER AND VILLA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:T
Authorized Official - Last Name:HAEMMERLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-799-4451
Mailing Address - Street 1:5920 VENTURE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-2166
Mailing Address - Country:US
Mailing Address - Phone:614-760-7352
Mailing Address - Fax:614-760-7356
Practice Address - Street 1:806 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-2128
Practice Address - Country:US
Practice Address - Phone:330-725-4123
Practice Address - Fax:330-723-2412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-28
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH875825Medicaid