Madison Village Manor

LBN: Madison Village Manor
Madison Village Manor is an health care organization with primary practice located at 148 E Main St , Madison OH 44057-3226. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, which is considered as the primary health care specialty. Madison Village Manor can be contacted via phone (440) 428-6969, or through Serra, Anthony Michael via phone (440) 428-6969.

Contact Information

Primary practice address
148 E Main St Madison OH 44057-3226
Phone: (440) 428-6969
Fax: (440) 428-6360
Website:
Map and Directions
Authorized official contact:
Name: Serra, Anthony Michael NHA
Phone: (440) 428-6969

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X 2675 Ohio

Profile Details

NPI number 1972786705
LBN Legal business name Madison Village Manor
DBA Doing business as
Authorized official Serra, Anthony Michael NHA
Entity Organization
Organization subpart 1 No
Enumeration date Dec 15th, 2007
Last updated Jun 19th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972786705 NPPES
Ohio MEDICAID 0345442

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