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NPI Code Detail

MEDICARE: ROSE-MARY THE JOHANNA GRASSELLI REHABILITATION AND EDUCATION CENTER

MEDICARE: ROSE-MARY THE JOHANNA GRASSELLI REHABILITATION AND EDUCATION CENTER
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
1320900000XIntellectual and/or Developmental Disabilities Community Based Residential Treatment 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 : 1740349208
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROSE-MARY THE JOHANNA GRASSELLI REHABILITATION AND EDUCATION CENTER
Provider Business Mailing Address
First Line : 5500 S MARGINAL RD STE 110
Second Line :
City : CLEVELAND
State : OH
Zip : 44103-1009
Country : US
Telephone Number : 216-481-4823
Fax Number : 216-481-4154
Provider Business Practice Location Address
First Line : 5500 S MARGINAL RD STE 110
Second Line :
City : CLEVELAND
State : OH
Zip : 44103-1009
Country : US
Telephone Number : 216-481-4823
Fax Number : 216-481-4154
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : GINA KERMAN
Credential :
Telephone Number : 216-481-4823
Provider Enumeration Date : 12/08/2006
Last Update Date : 12/01/2025

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Directions to “ROSE-MARY THE JOHANNA GRASSELLI REHABILITATION AND EDUCATION CENTER ” Practice Location

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