TAEJ RESIDENTIAL CARE LLC NPI 1679756837

NPI Information

TAEJ RESIDENTIAL CARE, LLC is an assisted living facility in Mansfield, OH. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. TAEJ RESIDENTIAL CARE, LLC NPI is 1679756837. The provider is registered as an organization entity type.
The provider Is Doing Business As Diamond View Rcf.

The provider's business location address is:

111 S DIAMOND ST
MANSFIELD, OH
ZIP 44902-510
Phone: (419) 522-4450
Fax: (419) 522-4552

The provider's authorized official is Michael F Jedra .
The authorized official title is Administrator and has the following contact phone number (419) 522-4450.

The CLIA number assigned to this NPI record is 36D0680192 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/11/2007 and was last updated on 12/11/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.