Healthcare Provider Details

I. General information

NPI: 1700189784
Provider Name (Legal Business Name): CEDARVIEW NURSING & REHABILITATION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2010
Last Update Date: 06/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 OREGONIA RD
LEBANON OH
45036-1983
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 513-932-1121
  • Fax: 513-934-0899
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 State

VIII. Authorized Official

Name: JOSEPH HERTANU
Title or Position: OWNER
Credential:
Phone: 216-381-5794