| NPI | 1669803862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICE JONES Lpn 440-812-4878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: OH PN-125152) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: OH PN-125152) |
| 311500000X Alzheimer Center (Dementia Center) (Licence: OH PN-125152) | |
| 313M00000X Nursing Facility/Intermediate Care Facility (Licence: OH PN-125152) | |
| 314000000X Skilled Nursing Facility (Licence: OH PN-125152) | |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2013-12-12 |