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General NPI Number Information
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NPI Number | 1427169564
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Entity Type | Organization
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Legal Business Name | RIDGECREST HEALTHCARE GROUP INC.
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1926 RIDGE AVE SE
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City | WARREN
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State | OH
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Zip | 44484-2821
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Country | US
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Telephone | 330-369-4672
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Fax | 330-369-2367
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Provider Business Mailing Address
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Address Line | 1926 RIDGE AVE SE
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City | WARREN
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State | OH
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Zip | 44484-2821
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Country | US
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Telephone | 330-369-4672
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Fax | 330-369-2367
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Authorized Official
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Title or Position | ITS VP
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Name | WILLIAM I WEISBERG
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Credential |
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Telephone | 216-292-5706
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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 | 0517N
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License Number State | OH
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