Healthcare Provider Details

I. General information

NPI: 1720483928
Provider Name (Legal Business Name): BEEGHLY OAKS OPERATING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2014
Last Update Date: 06/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6505 MARKET ST
BOARDMAN OH
44512-3457
US

IV. Provider business mailing address

6505 MARKET ST
BOARDMAN OH
44512-3457
US

V. Phone/Fax

Practice location:
  • Phone: 330-884-2300
  • Fax:
Mailing address:
  • Phone:
  • 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: MARK FRIEDMAN
Title or Position: MEMBER
Credential:
Phone: 917-596-1800