Healthcare Provider Details

I. General information

NPI: 1629491782
Provider Name (Legal Business Name): BEVERLY HEALTH CARE CO., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2014
Last Update Date: 01/26/2023
Certification Date: 01/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 PINECREST DR
BEVERLY OH
45715-8909
US

IV. Provider business mailing address

2875 CENTER RD STE 6
BRUNSWICK OH
44212-2319
US

V. Phone/Fax

Practice location:
  • Phone: 740-984-4262
  • Fax:
Mailing address:
  • Phone: 216-772-1105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN PARSONS
Title or Position: VP/GENERAL COUNSEL
Credential:
Phone: 216-772-1105