Healthcare Provider Details

I. General information

NPI: 1942207923
Provider Name (Legal Business Name): ANNA MARIA OF AURORA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

889 N AURORA RD
AURORA OH
44202-9537
US

IV. Provider business mailing address

889 N AURORA RD
AURORA OH
44202-9537
US

V. Phone/Fax

Practice location:
  • Phone: 330-562-6171
  • Fax: 330-562-3572
Mailing address:
  • Phone: 330-562-6171
  • Fax: 330-562-3572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number173
License Number StateOH

VIII. Authorized Official

Name: MR. GEORGE NORTON
Title or Position: VICE PRESIDENT
Credential:
Phone: 330-562-6171