Healthcare Provider Details

I. General information

NPI: 1144528076
Provider Name (Legal Business Name): CEDARS OF LEBANON NURSING & REHABILITATION CENTER, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2011
Last Update Date: 03/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 E SILVER ST
LEBANON OH
45036-1812
US

IV. Provider business mailing address

2120 S GREEN RD SUITE 02
SOUTH EUCLID OH
44121-3349
US

V. Phone/Fax

Practice location:
  • Phone: 513-932-0300
  • Fax:
Mailing address:
  • Phone: 216-381-5794
  • Fax: 216-381-5797

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: JOSEPH HERTANU
Title or Position: SOLE MBR
Credential:
Phone: 216-381-5794