Provider Demographics
NPI:1790183150
Name:WC-WASHINGTON CH OPS, LLC
Entity Type:Organization
Organization Name:WC-WASHINGTON CH OPS, LLC
Other - Org Name:CARRIAGE COURT WASHINGTON COURT HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:740-333-3434
Mailing Address - Street 1:500 N GLENN AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON COURT HOUSE
Mailing Address - State:OH
Mailing Address - Zip Code:43160-2713
Mailing Address - Country:US
Mailing Address - Phone:740-333-3434
Mailing Address - Fax:740-333-3434
Practice Address - Street 1:500 N GLENN AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON COURT HOUSE
Practice Address - State:OH
Practice Address - Zip Code:43160-2713
Practice Address - Country:US
Practice Address - Phone:740-333-3434
Practice Address - Fax:740-333-3434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2058R310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility