Provider Demographics
NPI:1285885798
Name:DAYTON HEALTH CARE, INC.
Entity type:Organization
Organization Name:DAYTON HEALTH CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-204-1040
Mailing Address - Street 1:782 W ORANGE RD
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-8922
Mailing Address - Country:US
Mailing Address - Phone:330-204-1040
Mailing Address - Fax:
Practice Address - Street 1:4830 SALEM AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45416-1739
Practice Address - Country:US
Practice Address - Phone:937-278-2692
Practice Address - Fax:937-278-9016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-02
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0169N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2902390Medicaid
OH365322Medicare Oscar/Certification