- Enrollment id
- O20070108000010
- Enrollment state
- OH
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1902907959
- Multiple npi flag
- N
- Ccn
- 366028
- Associate id
- 0941200430
- Organization name
- ORION MANSFIELD LLC
- Doing business as name
- WOODSIDE VILLAGE CARE CENTER
- Incorporation date
- 2006-09-08
- Incorporation state
- DE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- WOODSIDE VILLAGE CARE CENTER
- Affiliation entity name
- ATRIUM CENTERS
- Affiliation entity id
- 54
- Address line 1
- 841 W MARION RD
- City
- MT GILEAD
- State
- OH
- Zip code
- 433381038