Provider Demographics
NPI:1043719321
Name:FC STREETSBORO HEIGHTS OPCO LLC
Entity Type:Organization
Organization Name:FC STREETSBORO HEIGHTS OPCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MR
Authorized Official - First Name:ROB
Authorized Official - Middle Name:
Authorized Official - Last Name:LEINBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-767-9500
Mailing Address - Street 1:9975 GREENTREE PKWY
Mailing Address - Street 2:
Mailing Address - City:STREETSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:44241-4328
Mailing Address - Country:US
Mailing Address - Phone:330-342-9100
Mailing Address - Fax:
Practice Address - Street 1:9975 GREENTREE PKWY
Practice Address - Street 2:
Practice Address - City:STREETSBORO
Practice Address - State:OH
Practice Address - Zip Code:44241-4328
Practice Address - Country:US
Practice Address - Phone:330-342-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-01
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility