Provider Demographics
NPI:1194086439
Name:VIENNA CARE CENTER, INC.
Entity type:Organization
Organization Name:VIENNA CARE CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:BUNNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-529-7272
Mailing Address - Street 1:70 PARK AVE W
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44902-1624
Mailing Address - Country:US
Mailing Address - Phone:419-529-7272
Mailing Address - Fax:419-522-2040
Practice Address - Street 1:125 E NATIONAL RD
Practice Address - Street 2:
Practice Address - City:SOUTH VIENNA
Practice Address - State:OH
Practice Address - Zip Code:45369-9742
Practice Address - Country:US
Practice Address - Phone:937-568-4542
Practice Address - Fax:877-448-6532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-04
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility