Provider Demographics
NPI:1912989179
Name:ZANDEX HEALTH CARE CORPORATION
Entity Type:Organization
Organization Name:ZANDEX HEALTH CARE CORPORATION
Other - Org Name:FOREST HILL CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:LYLE
Authorized Official - Middle Name:W
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:V
Authorized Official - Credentials:CFO
Authorized Official - Phone:740-588-2154
Mailing Address - Street 1:PO BOX 730
Mailing Address - Street 2:1122 TAYLOR STREET
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43702-0730
Mailing Address - Country:US
Mailing Address - Phone:740-454-1400
Mailing Address - Fax:740-454-7439
Practice Address - Street 1:100 RESERVOIR RD
Practice Address - Street 2:
Practice Address - City:ST CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950
Practice Address - Country:US
Practice Address - Phone:740-695-7233
Practice Address - Fax:740-695-2499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4626313M00000X
OH1864N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Not Answered314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0657936Medicaid
OH0657936Medicaid