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NPI Code Detail

MEDICARE: SNH OHIO TENANT LLC

MEDICARE: SNH OHIO TENANT 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
1314000000XSkilled Nursing Facility
2310400000XAssisted Living Facility

General Provider Information

NPI Number : 1790332088
Entity Type Code : Organization
Provider Name (Legal Business Name) : SNH OHIO TENANT LLC
Provider Business Mailing Address
First Line : 255 WASHINGTON ST STE 300
Second Line :
City : NEWTON
State : MA
Zip : 02458-1634
Country : US
Telephone Number : 617-796-8350
Fax Number :
Provider Business Practice Location Address
First Line : 4590 KNIGHTSBRIDGE BLVD
Second Line :
City : COLUMBUS
State : OH
Zip : 43214-4327
Country : US
Telephone Number : 614-451-6793
Fax Number : 614-273-2450
Authorized Official
Title or Position : PRESIDENT & CHIEF OPERATING OFFICER
Name : JENNIFER F. MINTZER
Credential :
Telephone Number : 617-796-8350
Provider Enumeration Date : 08/21/2019
Last Update Date : 10/11/2021

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Directions to “SNH OHIO TENANT LLC ” Practice Location

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