Provider Demographics
NPI:1396067138
Name:WAYNE MANOR, INC
Entity type:Organization
Organization Name:WAYNE MANOR, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HORST
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:330-345-9050
Mailing Address - Street 1:4110 E SMITHVILLE WESTERN RD
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-7782
Mailing Address - Country:US
Mailing Address - Phone:330-345-9050
Mailing Address - Fax:330-345-9212
Practice Address - Street 1:4110 E SMITHVILLE WESTERN RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-7782
Practice Address - Country:US
Practice Address - Phone:330-345-9050
Practice Address - Fax:330-345-9212
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPRENGER HEALTH CARE SYSTEMS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1840310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility