The Gables

LBN: Madison Village Manor, Inc
The Gables is an health care organization with primary practice located at 731 N Lake St , Madison OH 44057-3152. 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, Inc can be contacted via phone (440) 428-1519, or through Serra, Anthony Michael via phone (440) 428-1519.

Contact Information

Primary practice address
731 N Lake St Madison OH 44057-3152
Phone: (440) 428-1519
Fax: (440) 428-6360
Website:
Map and Directions
Authorized official contact:
Name: Serra, Anthony Michael NHA
Phone: (440) 428-1519

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X 4310178 Ohio

Profile Details

NPI number 1154504983
LBN Legal business name Madison Village Manor, Inc
DBA Doing business as The Gables
Authorized official Serra, Anthony Michael NHA
Entity Organization
Organization subpart 1 Yes
Enumeration date Dec 15th, 2007
Last updated Dec 15th, 2007 - about 18 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 1154504983 NPPES
Ohio MEDICAID 1724665

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