Healthcare Provider Details

I. General information

NPI: 1245303403
Provider Name (Legal Business Name): GENEVA VILLAGE RETIREMENT COMMUNITY, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 S BROADWAY
GENEVA OH
44041-9143
US

IV. Provider business mailing address

1140 S BROADWAY
GENEVA OH
44041-9143
US

V. Phone/Fax

Practice location:
  • Phone: 440-466-5809
  • Fax:
Mailing address:
  • Phone: 440-466-5809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. MICHAEL FRANCUS
Title or Position: MANAGING MEMBER
Credential:
Phone: 330-475-8512