Healthcare Provider Details

I. General information

NPI: 1316247976
Provider Name (Legal Business Name): STONE CROSSING MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2010
Last Update Date: 09/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

836 34TH ST NW
CANTON OH
44709-2947
US

IV. Provider business mailing address

836 34TH ST NW
CANTON OH
44709-2947
US

V. Phone/Fax

Practice location:
  • Phone: 330-492-7131
  • Fax: 330-492-1661
Mailing address:
  • Phone: 330-492-7131
  • Fax: 330-492-1661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1498N
License Number StateOH

VIII. Authorized Official

Name: MRS. SHIRLEY ARMSTRONG
Title or Position: SOLE MEMBER
Credential:
Phone: 330-499-2838