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General NPI Number Information
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NPI Number | 1902926405
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Entity Type | Organization
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Legal Business Name | AURORA ROAD GROUP HOME
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 01/31/2020
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Provider Practice Location Address
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Address Line | 9772 DIAGONAL RD
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City | MANTUA
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State | OH
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Zip | 44255-9128
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Country | US
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Telephone | 330-274-2272
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Fax |
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Provider Business Mailing Address
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Address Line | 37125 AURORA RD
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City | SOLON
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State | OH
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Zip | 44139-4659
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Country | US
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Telephone | 330-440-2483
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MR. GREG SNYDER
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Credential |
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Telephone | 330-840-6851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310500000X
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Taxonomy Name | Mental Illness Intermediate Care Facility
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License Number | 256191
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License Number State | OH
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