Healthcare Provider Details

I. General information

NPI: 1235730748
Provider Name (Legal Business Name): CANTON REHABILITATION AND NURSING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2020
Last Update Date: 11/03/2020
Certification Date: 11/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2714 13TH ST NW
CANTON OH
44708-3121
US

IV. Provider business mailing address

1080 MCDONALD AVE STE 213
BROOKLYN NY
11230-2633
US

V. Phone/Fax

Practice location:
  • Phone: 330-456-2842
  • Fax:
Mailing address:
  • Phone: 608-448-6200
  • 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: ISAAK MARKOVITS
Title or Position: CFO
Credential:
Phone: 608-448-6200