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General NPI Number Information
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NPI Number | 1538159256
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Entity Type | Organization
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Legal Business Name | RAE-ANN CENTER, INC.
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Dates
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Enumeration Date | 10/25/2005
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Last Update Date | 08/08/2014
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Provider Practice Location Address
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Address Line | 4650 ROCKY RIVER DR
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City | CLEVELAND
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State | OH
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Zip | 44135-3846
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Country | US
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Telephone | 216-267-5445
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 40175
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City | BAY VILLAGE
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State | OH
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Zip | 44140-0175
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Country | US
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Telephone | 440-835-3005
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Fax | 440-871-3776
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. JOHN S. GRIFFITHS
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Credential | LNHA
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Telephone | 440-835-3005
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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 | 5150
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License Number State | OH
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