Healthcare Provider Details

I. General information

NPI: 1376516328
Provider Name (Legal Business Name): HAMLET HEALTH CARE OPERATOR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 12/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 CLEVELAND ST
CHAGRIN FALLS OH
44022-2985
US

IV. Provider business mailing address

200 HAMLET HILLS DR
CHAGRIN FALLS OH
44022-2985
US

V. Phone/Fax

Practice location:
  • Phone: 440-247-4200
  • Fax: 440-247-7597
Mailing address:
  • Phone: 440-247-4201
  • Fax: 440-247-1291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0510N
License Number StateOH

VIII. Authorized Official

Name: MR. ELAN RUGGILL
Title or Position: VICE PRESIDENT
Credential:
Phone: 734-222-5275