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NPI Code Detail

MEDICARE: RAE-ANN CENTER, INC.

MEDICARE: RAE-ANN CENTER, 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
1314000000XSkilled Nursing Facility5150OH

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 : 1538159256
Entity Type Code : Organization
Provider Name (Legal Business Name) : RAE-ANN CENTER, INC.
Provider Business Mailing Address
First Line : PO BOX 40175
Second Line :
City : BAY VILLAGE
State : OH
Zip : 44140-0175
Country : US
Telephone Number : 440-835-3005
Fax Number : 440-871-3776
Provider Business Practice Location Address
First Line : 4650 ROCKY RIVER DR
Second Line :
City : CLEVELAND
State : OH
Zip : 44135-3846
Country : US
Telephone Number : 216-267-5445
Fax Number :
Authorized Official
Title or Position : VICE PRESIDENT
Name : MR. JOHN S. GRIFFITHS
Credential : LNHA
Telephone Number : 440-835-3005
Provider Enumeration Date : 10/25/2005
Last Update Date : 08/08/2014

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