Provider Demographics
NPI:1538326947
Name:WEBER HEALTH CARE CENTER, INC.
Entity Type:Organization
Organization Name:WEBER HEALTH CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ADELBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-647-2088
Mailing Address - Street 1:PO BOX 386
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:44090-0386
Mailing Address - Country:US
Mailing Address - Phone:440-647-2088
Mailing Address - Fax:
Practice Address - Street 1:214 E HERRICK AVE
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:OH
Practice Address - Zip Code:44090-1317
Practice Address - Country:US
Practice Address - Phone:440-647-2088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH36-G071OtherMEDICARE PROVIDER NO.
OH0450319OtherMEDICADE PROVIDER NUMBER
OH14958OtherMR/DD LICENSE NO.
OH4710183OtherODMR/DD FACILITY NO.