Provider Demographics
NPI:1285167221
Name:THE HOMESTEAD
Entity type:Organization
Organization Name:THE HOMESTEAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:SLEURZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-877-7700
Mailing Address - Street 1:850 SUNNYSIDE ST SW
Mailing Address - Street 2:
Mailing Address - City:HARTVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44632-9087
Mailing Address - Country:US
Mailing Address - Phone:330-877-7700
Mailing Address - Fax:330-877-7701
Practice Address - Street 1:880 SUNNYSIDE ST SW
Practice Address - Street 2:
Practice Address - City:HARTVILLE
Practice Address - State:OH
Practice Address - Zip Code:44632-9087
Practice Address - Country:US
Practice Address - Phone:330-877-7700
Practice Address - Fax:330-877-7701
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GENTLEBROOK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-04-06
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2768R310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility