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NPI Code Detail

MEDICARE: ARBORS AT FAIRLAWN CARE, LLC

MEDICARE: ARBORS AT FAIRLAWN CARE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043381635
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARBORS AT FAIRLAWN CARE, LLC
Provider Business Mailing Address
First Line : 111 W MICHIGAN ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53203-2903
Country : US
Telephone Number : 414-908-8119
Fax Number : 414-908-7105
Provider Business Practice Location Address
First Line : 575 S CLEVELAND MASSILLON RD
Second Line :
City : FAIRLAWN
State : OH
Zip : 44333-3019
Country : US
Telephone Number : 330-666-5866
Fax Number : 330-666-3215
Authorized Official
Title or Position : DIRECTOR OF COMPLIANCE
Name : DONNA JO MAASSEN
Credential :
Telephone Number : 414-908-8119
Provider Enumeration Date : 11/13/2006
Last Update Date : 03/27/2008

Similar Medicare Providers

1780892091 — MR. EDWIN PIERRE VINES MSPT
Practice Location Address:
575 S CLEVELAND MASSILLON RD
FAIRLAWN, OH
44333-3019
Practice Phone: 330-666-5866
Practice Fax: 330-666-3215
1700081494 — MRS. ROSANNE MARIE SHOVLIN PT
Practice Location Address:
575 S CLEVELAND MASSILLON RD
FAIRLAWN, OH
44333-3019
Practice Phone: 330-666-5866
Practice Fax:
1912103995 — MRS. ERIN M KOLONICH MA, CCC-SLP
Practice Location Address:
575 S CLEVELAND MASSILLON RD
FAIRLAWN, OH
44333-3019
Practice Phone: 330-666-5866
Practice Fax:
1326245309 — MR. MICHAEL A KOLONICH COTAL
Practice Location Address:
575 S CLEVELAND MASSILLON RD
FAIRLAWN, OH
44333-3019
Practice Phone: 330-666-5866
Practice Fax:
1154529741 — MRS. JULIENNE MARIE CARLQUIST DPT
Practice Location Address:
575 S CLEVELAND MASSILLON RD
FAIRLAWN, OH
44333-3019
Practice Phone: 330-666-5866
Practice Fax:
1578761508 — MR. CHAD EDWARD EVERSON PTA
Practice Location Address:
575 S CLEVELAND MASSILLON RD , THERAPY DEPT.
FAIRLAWN, OH
44333-3019
Practice Phone: 330-666-5866
Practice Fax: 330-666-3215

Directions to “ARBORS AT FAIRLAWN CARE, LLC ” Practice Location

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