MEDICARE: NORTH PARK CARE CENTER 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
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1699086942
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH PARK CARE CENTER LLC

Provider Business Mailing Address
First Line	:	14803 HOLLAND RD
Second Line	:
City	:	BROOKPARK
State	:	OH
Zip	:	44142-3065
Country	:	US
Telephone Number	:	216-803-1995
Fax Number	:	216-803-1999

Provider Business Practice Location Address
First Line	:	14801 HOLLAND RD
Second Line	:
City	:	BROOK PARK
State	:	OH
Zip	:	44142-3092
Country	:	US
Telephone Number	:	216-803-1995
Fax Number	:	216-803-1999

Authorized Official
Title or Position	:	CFO
Name	:	CHARLES CALABRASE
Credential	:
Telephone Number	:	216-302-2719

Provider Enumeration Date	:	07/01/2010
Last Update Date	:	02/23/2023

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