Healthcare Provider Details

I. General information

NPI: 1477285427
Provider Name (Legal Business Name): AVENTURA AT WALTON HILLS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2022
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19859 ALEXANDER RD
WALTON HILLS OH
44146-5345
US

IV. Provider business mailing address

1105 E COUNTY LINE RD STE 206
LAKEWOOD NJ
08701-2122
US

V. Phone/Fax

Practice location:
  • Phone: 440-439-4433
  • Fax:
Mailing address:
  • Phone: 610-686-3300
  • 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. MOISHE KASZIRER
Title or Position: COO
Credential:
Phone: 610-686-3300