Provider Demographics
NPI:1326865601
Name:FHS BENNINGTON, INC.
Entity type:Organization
Organization Name:FHS BENNINGTON, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF GOVERNMENT AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MUIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-793-2245
Mailing Address - Street 1:825 STATE ROUTE 61
Mailing Address - Street 2:
Mailing Address - City:MARENGO
Mailing Address - State:OH
Mailing Address - Zip Code:43334-9215
Mailing Address - Country:US
Mailing Address - Phone:440-793-2245
Mailing Address - Fax:440-614-0168
Practice Address - Street 1:825 STATE ROUTE 61
Practice Address - Street 2:
Practice Address - City:MARENGO
Practice Address - State:OH
Practice Address - Zip Code:43334-9215
Practice Address - Country:US
Practice Address - Phone:440-793-2245
Practice Address - Fax:440-614-0168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-26
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility