Provider Demographics
NPI:1053851055
Name:LEBANON HEALTHCARE LEASING, LLC
Entity Type:Organization
Organization Name:LEBANON HEALTHCARE LEASING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELI
Authorized Official - Middle Name:M
Authorized Official - Last Name:GUNZBURG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-658-1040
Mailing Address - Street 1:29225 CHAGRIN BLVD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4645
Mailing Address - Country:US
Mailing Address - Phone:440-658-1040
Mailing Address - Fax:
Practice Address - Street 1:700 MONROE RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-1409
Practice Address - Country:US
Practice Address - Phone:513-932-0105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-24
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1796N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility