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NPI Code Detail

MEDICARE: AJ CITYVIEW NURSING & REHAB OPCO LLC

MEDICARE: AJ CITYVIEW NURSING & REHAB OPCO LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility1814NOH

General Provider Information

NPI Number : 1457855983
Entity Type Code : Organization
Provider Name (Legal Business Name) : AJ CITYVIEW NURSING & REHAB OPCO LLC
Provider Business Mailing Address
First Line : 555 ANTHONY WAYNE TRL
Second Line :
City : WATERVILLE
State : OH
Zip : 43566-1516
Country : US
Telephone Number : 330-720-0406
Fax Number :
Provider Business Practice Location Address
First Line : 6606 CARNEGIE AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44103-4622
Country : US
Telephone Number : 216-361-1414
Fax Number : 216-361-2822
Authorized Official
Title or Position : ATTORNEY
Name : HAYLEY B WILLIAMS
Credential :
Telephone Number : 216-706-3936
Provider Enumeration Date : 03/20/2018
Last Update Date : 04/30/2018

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