Healthcare Provider Details

I. General information

NPI: 1629015433
Provider Name (Legal Business Name): ALLIANCE HEALTHCARE BRAEVIEW, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 01/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20611 EUCLID AVE
EUCLID OH
44117
US

IV. Provider business mailing address

29225 CHAGRIN BLVD. SUITE 230
CLEVELAND OH
44122
US

V. Phone/Fax

Practice location:
  • Phone: 216-486-9300
  • Fax: 216-486-2603
Mailing address:
  • Phone: 440-658-1040
  • Fax: 866-629-9730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number6127
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number6127
License Number StateOH

VIII. Authorized Official

Name: ELI M. GUNZBURG
Title or Position: MANAGING MEMBER
Credential:
Phone: 440-658-1040