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General NPI Number Information
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NPI Number | 1245303403
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Entity Type | Organization
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Legal Business Name | GENEVA VILLAGE RETIREMENT COMMUNITY, LTD
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1140 S BROADWAY
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City | GENEVA
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State | OH
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Zip | 44041-9143
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Country | US
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Telephone | 440-466-5809
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Fax |
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Provider Business Mailing Address
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Address Line | 1140 S BROADWAY
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City | GENEVA
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State | OH
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Zip | 44041-9143
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Country | US
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Telephone | 440-466-5809
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. MICHAEL FRANCUS
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Credential |
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Telephone | 330-475-8512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | OH
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