Provider Demographics
NPI:1124322813
Name:AUTUMN CARE CENTER, INC.
Entity type:Organization
Organization Name:AUTUMN CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HITCHENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-345-9199
Mailing Address - Street 1:151 PRICE RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-3317
Mailing Address - Country:US
Mailing Address - Phone:740-366-2321
Mailing Address - Fax:740-366-8600
Practice Address - Street 1:151 PRICE RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-3317
Practice Address - Country:US
Practice Address - Phone:740-366-2321
Practice Address - Fax:740-366-8600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility