Healthcare Provider Details

I. General information

NPI: 1982238754
Provider Name (Legal Business Name): JENNINGS CENTER FOR OLDER ADULTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2020
Last Update Date: 03/02/2020
Certification Date: 03/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10950 PINEGROVE TRL
CHARDON OH
44024-8389
US

IV. Provider business mailing address

10950 PINEGROVE TRL
CHARDON OH
44024-8389
US

V. Phone/Fax

Practice location:
  • Phone: 440-279-9400
  • Fax:
Mailing address:
  • Phone: 440-279-9400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. MATTHEW L. BOLLIN
Title or Position: CFO
Credential:
Phone: 216-581-2900