Healthcare Provider Details

I. General information

NPI: 1932942984
Provider Name (Legal Business Name): 600 NORTH BRUSH OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2024
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N BRUSH ST
FREMONT OH
43420-1402
US

IV. Provider business mailing address

30100 CHAGRIN BLVD
PEPPER PIKE OH
44124-5722
US

V. Phone/Fax

Practice location:
  • Phone: 419-334-9521
  • Fax:
Mailing address:
  • Phone: 516-545-0980
  • Fax:

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: RACHEL FRIEDMAN
Title or Position: MANAGER
Credential:
Phone: 327-552-6035