| NPI | 1891018750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETHANY ANN KOCH Program Manager 216-361-6141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: OH 00598) |
| Enumeration Date | 2010-03-08 |
| Last Update Date | 2010-03-08 |