Provider Demographics
NPI:1750348512
Name:BLANCHARD VALLEY HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:BLANCHARD VALLEY HOME CARE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CYTLAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-423-5497
Mailing Address - Street 1:15100 BIRCHAVEN LN
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-9773
Mailing Address - Country:US
Mailing Address - Phone:419-423-5351
Mailing Address - Fax:419-423-8967
Practice Address - Street 1:15100 BIRCHAVEN LN
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-9773
Practice Address - Country:US
Practice Address - Phone:419-423-5351
Practice Address - Fax:419-423-8967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2388205Medicaid
OH2388205Medicaid