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General NPI Number Information
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NPI Number | 1992593701
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Entity Type | Organization
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Legal Business Name | SCHOENBRUNN DIVINE OPCO LLC
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 2594 E HIGH AVE
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City | NEW PHILADELPHIA
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State | OH
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Zip | 44663-6737
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Country | US
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Telephone | 330-620-7828
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Fax |
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Provider Business Mailing Address
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Address Line | 5915 LANDERBROOK DR STE 350
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City | MAYFIELD HEIGHTS
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State | OH
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Zip | 44124-4063
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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 | CHIEF OPERATING OFFICER
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Name | JEFFREY DEGYANSKY
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Credential |
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Telephone | 330-620-7828
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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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