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General NPI Number Information
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NPI Number | 1902958267
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Entity Type | Organization
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Legal Business Name | FAIRVIEW VILLAGE RETIREMENT COMMUNITY, LTD
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4110 ROCKY RIVER DR
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City | CLEVELAND
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State | OH
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Zip | 44135-1175
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Country | US
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Telephone | 216-941-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 4110 ROCKY RIVER DR
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City | CLEVELAND
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State | OH
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Zip | 44135-1175
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Country | US
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Telephone | 216-941-6100
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. JANICE MARIE COLLINS
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Credential | LNHA
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Telephone | 330-920-6555
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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 |
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License Number State |
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