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General NPI Number Information
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NPI Number | 1285939850
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Entity Type | Organization
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Legal Business Name | ANNES OASIS LLC
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Dates
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Enumeration Date | 01/12/2011
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Last Update Date | 01/12/2011
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Provider Practice Location Address
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Address Line | 7090 WILSON MILLS RD
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City | CHESTERLAND
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State | OH
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Zip | 44026-1733
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Country | US
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Telephone | 440-423-3838
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Fax | 440-423-0383
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Provider Business Mailing Address
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Address Line | 7090 WILSON MILLS RD
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City | CHESTERLAND
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State | OH
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Zip | 44026-1733
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Country | US
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Telephone | 440-423-3838
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Fax | 440-423-0383
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Authorized Official
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Title or Position | OWNER
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Name | MR. PAUL D RADVANSKY
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Credential |
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Telephone | 440-423-3838
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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 | 1090AGH
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License Number State | OH
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