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General NPI Number Information
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NPI Number | 1861531881
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Entity Type | Organization
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Legal Business Name | SEASONS HEALTHCARE GROUP, LLC
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 03/17/2008
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Provider Practice Location Address
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Address Line | 456 SEASONS RD
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City | STOW
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State | OH
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Zip | 44224-1020
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Country | US
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Telephone | 330-688-5553
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Fax |
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Provider Business Mailing Address
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Address Line | 24579 BROADWAY AVE
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City | OAKWOOD VILLAGE
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State | OH
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Zip | 44146-6338
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. DARLA PERKINS
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Credential | ADMINISTRATOR
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Telephone | 330-688-5553
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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 | 6126
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License Number State | OH
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