| NPI | 1245787654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES STEVEN BOGAN Licensed Practical Nurse 216-804-6678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric (Licence: OH PN.127610) |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: OH PN.127610) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |