MEDICARE: NORTHFIELD VILLAGE RETIREMENT COMMUNITY, LTD.

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
1	314000000X	Skilled Nursing Facility	2385N	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2385N	OTHER	OH	NURSING FACILITY

General Provider Information

NPI Number	:	1477539070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHFIELD VILLAGE RETIREMENT COMMUNITY, LTD.

Provider Business Mailing Address
First Line	:	10267 NORTHFIELD RD
Second Line	:
City	:	NORTHFIELD
State	:	OH
Zip	:	44067-1418
Country	:	US
Telephone Number	:	330-468-1800
Fax Number	:	330-468-2666

Provider Business Practice Location Address
First Line	:	10267 NORTHFIELD RD
Second Line	:
City	:	NORTHFIELD
State	:	OH
Zip	:	44067-1418
Country	:	US
Telephone Number	:	330-468-1800
Fax Number	:	330-342-4719

Authorized Official
Title or Position	:	PRES., VRC, INC MANAGER
Name	:	MICHAEL J FRANCUS
Credential	:
Telephone Number	:	330-929-0009

Provider Enumeration Date	:	12/16/2005
Last Update Date	:	04/11/2014

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