Oak Haven Residential Care LLC

Organization Active NPI Assisted Living Facility · Cloverdale, OH

NPI 1780280560 · NPPES record last updated Dec 8, 2020

Key facts

NPI
1780280560
Entity type
Organization (NPI type 2)
Primary specialty
Assisted Living Facility 310400000X
Legal business name
OAK HAVEN RESIDENTIAL CARE LLC
Practice address
152 Main St
Cloverdale, OH 45827-9778
Phone
(419) 488-2310
Fax
(419) 488-2321
NPI assigned
Dec 8, 2020
Organization subpart
No

Authorized official

Name
Mrs. Sherry Kaye Webb, LPN
Title
Administrator
Phone
(419) 615-3357

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2273945Oak Haven Residential Care Center
152 Main Street, Cloverdale, OH 45827
Certificate of waiverDec 20, 2026

National Provider Directory

Tax ID family
Oak Haven Residential Care Center LLC (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Yes

Addresses

Primary practice location

152 Main St
Cloverdale, OH 45827-9778

Mailing address

PO Box 86
Cloverdale, OH 45827-0086
Phone (419) 488-2310

Other identifiers

IdentifierTypeStateIssuer
0109295MedicaidOH

Other providers in Cloverdale, OH

All providers in Cloverdale, OH · Assisted Living Facility in Ohio

Sources for this page

Verify at the official NPI Registry.