MEDICARE: OAK GROVE HEALTH & REHAB 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	:	1932718053
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OAK GROVE HEALTH & REHAB CENTER, LLC

Provider Business Mailing Address
First Line	:	23700 COMMERCE PARK
Second Line	:
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-5827
Country	:	US
Telephone Number	:	216-292-5706
Fax Number	:

Provider Business Practice Location Address
First Line	:	776 OAK GROVE RD
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23320-3728
Country	:	US
Telephone Number	:	757-261-4000
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	WILLIAM I. WEISBERG
Credential	:
Telephone Number	:	216-292-5706

Provider Enumeration Date	:	07/24/2020
Last Update Date	:	01/14/2022

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