Provider Demographics
NPI:1033495148
Name:HARRISON PAVILION NURSING & REHABILITATION CENTER LTD
Entity Type:Organization
Organization Name:HARRISON PAVILION NURSING & REHABILITATION CENTER LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:GILLILAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-528-0660
Mailing Address - Street 1:100 N MAIN ST
Mailing Address - Street 2:UNIT 420
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44022-2767
Mailing Address - Country:US
Mailing Address - Phone:440-528-0660
Mailing Address - Fax:440-528-0662
Practice Address - Street 1:2171 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-8159
Practice Address - Country:US
Practice Address - Phone:513-662-5800
Practice Address - Fax:513-389-4584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility