Provider Demographics
NPI:1487052940
Name:WC-GROVE CITY OPS, LLC
Entity type:Organization
Organization Name:WC-GROVE CITY OPS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOENING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-871-8000
Mailing Address - Street 1:2320 SONORA DR
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-2423
Mailing Address - Country:US
Mailing Address - Phone:614-871-8000
Mailing Address - Fax:614-871-8000
Practice Address - Street 1:2320 SONORA DR
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-2423
Practice Address - Country:US
Practice Address - Phone:614-871-8000
Practice Address - Fax:614-871-8000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1984R310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility