- Enrollment id
- O20031209001098
- Enrollment state
- OH
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1568491694
- Multiple npi flag
- N
- Ccn
- 365475
- Associate id
- 6709782873
- Organization name
- LIBERTY NURSING CENTER OF MANSFIELD, INC.
- Incorporation date
- 2003-08-01
- Incorporation state
- OH
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Nursing home provider name
- LIBERTY NURSING CENTER OF MANSFIELD
- Address line 1
- 535 LEXINGTON AVE
- City
- MANSFIELD
- State
- OH
- Zip code
- 449071502