Healthcare Provider Details

I. General information

NPI: 1790311082
Provider Name (Legal Business Name): FHS FAIRLAWN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2020
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3558 RIDGEWOOD RD
FAIRLAWN OH
44333-3122
US

IV. Provider business mailing address

25000 COUNTRY CLUB BLVD STE 255
NORTH OLMSTED OH
44070-5337
US

V. Phone/Fax

Practice location:
  • Phone: 330-472-0296
  • Fax:
Mailing address:
  • Phone: 440-793-2245
  • Fax: 440-614-0168

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: SANDY MUIR
Title or Position: VP OF GOVERNMENT AFFAIRS
Credential:
Phone: 440-793-2245