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General NPI Number Information
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NPI Number | 1598911356
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Entity Type | Organization
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Legal Business Name | ST. CLARENCE GEAC
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Dates
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Enumeration Date | 08/13/2008
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Last Update Date | 08/13/2008
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Provider Practice Location Address
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Address Line | 30344 LORAIN RD.
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City | NORTH OLMSTED
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State | OH
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Zip | 44070
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Country | US
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Telephone | 440-777-9300
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Fax | 440-777-9301
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Provider Business Mailing Address
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Address Line | 30344 LORAIN RD.
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City | NORTH OLMSTED
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State | OH
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Zip | 44070
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Country | US
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Telephone | 440-777-9300
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Fax | 440-777-9301
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. PATRICIA A. ZINGALE
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Credential |
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Telephone | 440-777-9300
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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 | 2481R
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License Number State | OH
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