Provider Demographics
NPI:1063807915
Name:RESIDENTIAL NURSING CARE LLC
Entity type:Organization
Organization Name:RESIDENTIAL NURSING CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RONDA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:BEATTY-CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:740-347-5004
Mailing Address - Street 1:PO BOX 110
Mailing Address - Street 2:
Mailing Address - City:CORNING
Mailing Address - State:OH
Mailing Address - Zip Code:43730-0110
Mailing Address - Country:US
Mailing Address - Phone:740-347-5004
Mailing Address - Fax:
Practice Address - Street 1:114 THRESHER ST.
Practice Address - Street 2:POST OFFICE BOX 110
Practice Address - City:CORNING
Practice Address - State:OH
Practice Address - Zip Code:43730-0110
Practice Address - Country:US
Practice Address - Phone:740-347-5004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health