Provider Demographics
NPI:1588281489
Name:ALS PEEBLES, INC
Entity type:Organization
Organization Name:ALS PEEBLES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CASEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-350-9095
Mailing Address - Street 1:26261 MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:COOLVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45723-9205
Mailing Address - Country:US
Mailing Address - Phone:740-415-1138
Mailing Address - Fax:201-661-2846
Practice Address - Street 1:25773 STATE ROUTE 41
Practice Address - Street 2:
Practice Address - City:PEEBLES
Practice Address - State:OH
Practice Address - Zip Code:45660-8953
Practice Address - Country:US
Practice Address - Phone:740-415-1138
Practice Address - Fax:201-661-2846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility