Healthcare Provider Details

I. General information

NPI: 1194279158
Provider Name (Legal Business Name): AHC OF LANDERHAVEN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2016
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2108 LANDER RD
MAYFIELD HEIGHTS OH
44124-4152
US

IV. Provider business mailing address

2108 LANDER RD
MAYFIELD HEIGHTS OH
44124-4152
US

V. Phone/Fax

Practice location:
  • Phone: 440-443-0345
  • Fax:
Mailing address:
  • Phone: 440-443-0345
  • 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: MR. NATHAN OXNAM
Title or Position: PRESIDENT
Credential:
Phone: 385-622-4500