Basic Information
| Provider Information | |||||||||
| NPI: | 1174727192 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BETHESDA HEALTH AND REHAB CENTER, INC. | ||||||||
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| OtherOrganizationName: | EMERALD POINTE HEALTH AND REHABILITATION CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 782 W ORANGE RD | ||||||||
| Address2: | |||||||||
| City: | DELAWARE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430158922 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3302041040 | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 MICHELLI ST | ||||||||
| Address2: | |||||||||
| City: | BARNESVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 437139335 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7404255400 | ||||||||
| FaxNumber: | 7404251719 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2007 | ||||||||
| LastUpdateDate: | 05/07/2018 | ||||||||
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| AuthorizedOfficialLastName: | SPEELMAN | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3309367158 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
ID Information
| ID | Type | State | Issuer | Description | 2768116 | 05 | OH | MEDICAID |