MEDICARE: ELIZA JENNINGS INC

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	4116	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

General Provider Information

NPI Number	:	1497759849
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELIZA JENNINGS INC

Provider Business Mailing Address
First Line	:	26376 JOHN RD
Second Line	:
City	:	OLMSTED FALLS
State	:	OH
Zip	:	44138-1277
Country	:	US
Telephone Number	:	440-235-7100
Fax Number	:	440-235-7115

Provider Business Practice Location Address
First Line	:	26376 JOHN RD
Second Line	:
City	:	OLMSTED FALLS
State	:	OH
Zip	:	44138-1277
Country	:	US
Telephone Number	:	440-235-7100
Fax Number	:	440-235-7115

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. MAUREEN MOFFATTE
Credential	:	LNHA
Telephone Number	:	440-235-7100

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	08/22/2020

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Directions to “ELIZA JENNINGS INC ” Practice Location

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