Great Trail Care, LLC

Organization Active NPI Skilled Nursing Facility · Minerva, OH

NPI 1437212628 · NPPES record last updated Feb 25, 2008

Key facts

NPI
1437212628
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
Legal business name
GREAT TRAIL CARE, LLC
Practice address
400 Carolyn CT
Minerva, OH 44657-8703
Phone
(330) 868-4104
Fax
(330) 868-7714
NPI assigned
Dec 18, 2006
Organization subpart
No

Authorized official

Name
Donna Jo Maassen
Title
Director of Compliance
Phone
(414) 908-8119

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Yes

Addresses

Primary practice location

400 Carolyn CT
Minerva, OH 44657-8703

Mailing address

111 W Michigan St
Milwaukee, WI 53203-2903
Phone (414) 908-8119

Other identifiers

IdentifierTypeStateIssuer
2007303MedicaidOH

Other names

  • Great Trail Care Center Doing business as

Other providers in Minerva, OH

All providers in Minerva, OH · Skilled Nursing Facility in Ohio

Sources for this page

Verify at the official NPI Registry.