Basic Information
| Provider Information | |||||||||
| NPI: | 1689928707 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADRIAN NURSING & REHABILITATION CENTER LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 N MAIN ST | ||||||||
| Address2: | STE 420 | ||||||||
| City: | CHAGRIN FALLS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440222767 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4405280660 | ||||||||
| FaxNumber: | 4405280662 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 N MAIN ST | ||||||||
| Address2: | STE 420 | ||||||||
| City: | CHAGRIN FALLS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440222767 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4405280660 | ||||||||
| FaxNumber: | 4405280662 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2012 | ||||||||
| LastUpdateDate: | 10/29/2012 | ||||||||
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| AuthorizedOfficialLastName: | SMILOVITZ | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
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| AuthorizedOfficialTitleorPosition: | SOLE MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 4405280660 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.