Healthcare Provider Details

I. General information

NPI: 1477539070
Provider Name (Legal Business Name): NORTHFIELD VILLAGE RETIREMENT COMMUNITY, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2005
Last Update Date: 04/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10267 NORTHFIELD RD
NORTHFIELD OH
44067-1418
US

IV. Provider business mailing address

10267 NORTHFIELD RD
NORTHFIELD OH
44067-1418
US

V. Phone/Fax

Practice location:
  • Phone: 330-468-1800
  • Fax: 330-342-4719
Mailing address:
  • Phone: 330-468-1800
  • Fax: 330-468-2666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number2385N
License Number StateOH

VIII. Authorized Official

Name: MICHAEL J FRANCUS
Title or Position: PRES., VRC, INC MANAGER
Credential:
Phone: 330-929-0009