Healthcare Provider Details

I. General information

NPI: 1831238104
Provider Name (Legal Business Name): CLEARHARBOR OPERATING CO., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4121 TOD AVE NW
WARREN OH
44485-1258
US

IV. Provider business mailing address

725 BOARDMAN CANFIELD RD BUILDING Q
BOARDMAN OH
44512-4380
US

V. Phone/Fax

Practice location:
  • Phone: 330-726-6047
  • Fax: 330-726-6097
Mailing address:
  • Phone: 330-726-6047
  • Fax: 330-726-6097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. JOSEPH CILONE
Title or Position: VICE PRESIDENT OF OPERATIONS
Credential:
Phone: 330-565-1097