Healthcare Provider Details

I. General information

NPI: 1396708848
Provider Name (Legal Business Name): GEAUGA REHABILITATION ENGINEERING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 08/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 MENTOR AVE SUITE C
MENTOR OH
44060-5842
US

IV. Provider business mailing address

13376 RAVENNA RD
CHARDON OH
44024-9007
US

V. Phone/Fax

Practice location:
  • Phone: 440-266-0250
  • Fax: 440-266-0251
Mailing address:
  • Phone: 440-285-5785
  • Fax: 440-285-5786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberLPO78
License Number StateOH

VIII. Authorized Official

Name: MR. JONATHAN NAFT
Title or Position: PRESIDENT
Credential: LPO
Phone: 440-285-5785