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General NPI Number Information
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NPI Number | 1891080875
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Entity Type | Organization
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Legal Business Name | MENORAH PARK CENTER FOR SENIOR LIVING
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Dates
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Enumeration Date | 06/17/2011
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Last Update Date | 06/17/2011
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Provider Practice Location Address
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Address Line | 27100 CEDAR RD
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City | BEACHWOOD
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State | OH
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Zip | 44122-1109
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Country | US
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Telephone | 216-831-6500
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Fax | 216-831-5492
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Provider Business Mailing Address
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Address Line | 27100 CEDAR RD
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City | BEACHWOOD
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State | OH
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Zip | 44122-1109
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Country | US
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Telephone | 216-831-6500
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Fax | 216-831-5492
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | STEVEN RAICHILSON
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Credential |
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Telephone | 216-831-6500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | 022122050
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License Number State | OH
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