Provider Demographics
NPI:1801855739
Name:GOLDEN KEY CORP OF KENTON
Entity Type:Organization
Organization Name:GOLDEN KEY CORP OF KENTON
Other - Org Name:THE CORINTHIAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:K
Authorized Official - Last Name:WILKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-673-1295
Mailing Address - Street 1:320 N WAYNE ST
Mailing Address - Street 2:
Mailing Address - City:KENTON
Mailing Address - State:OH
Mailing Address - Zip Code:43326-1536
Mailing Address - Country:US
Mailing Address - Phone:419-673-1295
Mailing Address - Fax:419-673-9834
Practice Address - Street 1:320 N WAYNE ST
Practice Address - Street 2:
Practice Address - City:KENTON
Practice Address - State:OH
Practice Address - Zip Code:43326-1536
Practice Address - Country:US
Practice Address - Phone:419-673-1295
Practice Address - Fax:419-673-9834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-20
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1496N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0184929Medicaid
OH0184929Medicaid
OH366030Medicare Oscar/Certification