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General NPI Number Information
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NPI Number | 1215690680
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Entity Type | Organization
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Legal Business Name | ECHELON ASSISTED LIVING OPERATIONS
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Dates
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Enumeration Date | 10/21/2021
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Last Update Date | 10/21/2021
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Provider Practice Location Address
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Address Line | 635 N HUNTINGTON ST
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City | MEDINA
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State | OH
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Zip | 44256-1871
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Country | US
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Telephone | 330-591-2777
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Fax |
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Provider Business Mailing Address
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Address Line | 635 N HUNTINGTON ST
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City | MEDINA
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State | OH
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Zip | 44256-1871
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Country | US
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Telephone | 330-591-2777
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF ADMINISTRATIVE SERVICES
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Name | EVA BOCHONOWICZ
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Credential |
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Telephone | 330-313-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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