Provider Demographics
NPI:1740739739
Name:SPRENGER HEALTH CARE OF MASSILLON SNF, INC
Entity Type:Organization
Organization Name:SPRENGER HEALTH CARE OF MASSILLON SNF, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-989-5239
Mailing Address - Street 1:3905 OBERLIN AVE
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-2853
Mailing Address - Country:US
Mailing Address - Phone:440-989-5200
Mailing Address - Fax:
Practice Address - Street 1:205 ROHR AVE NW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-3671
Practice Address - Country:US
Practice Address - Phone:440-989-5200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-02
Last Update Date:2016-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility