- Enrollment id
- O20070321000000
- Enrollment state
- OH
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1275524480
- Multiple npi flag
- N
- Ccn
- 365998
- Associate id
- 6002919503
- Organization name
- HOLZER SENIOR CARE CENTER
- Doing business as name
- HOLZER SENIOR CARE CENTER
- Incorporation date
- 1996-12-27
- Incorporation state
- OH
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Nursing home provider name
- HOLZER SENIOR CARE CENTER
- Address line 1
- 380 COLONIAL DR
- City
- BIDWELL
- State
- OH
- Zip code
- 456149215