Provider Demographics
NPI:1053665794
Name:SAGINAW NURSING & REHABILITATION CENTER LLC
Entity Type:Organization
Organization Name:SAGINAW NURSING & REHABILITATION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SMILOVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-528-0660
Mailing Address - Street 1:100 N MAIN ST
Mailing Address - Street 2:STE 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:
Practice Address - Street 1:100 N MAIN ST
Practice Address - Street 2:STE 420
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44022-2767
Practice Address - Country:US
Practice Address - Phone:440-528-0660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-02
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility