Provider Demographics
NPI:1457744013
Name:SKILLSMED INC.
Entity Type:Organization
Organization Name:SKILLSMED INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-207-7355
Mailing Address - Street 1:1156 W WESTERN RESERVE RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44514-3542
Mailing Address - Country:US
Mailing Address - Phone:330-629-2919
Mailing Address - Fax:330-629-2915
Practice Address - Street 1:1156 W WESTERN RESERVE RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44514-3542
Practice Address - Country:US
Practice Address - Phone:330-629-2919
Practice Address - Fax:330-629-2915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-06
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility