Provider Demographics
NPI:1073119400
Name:ANNA MARIA OF AURORA, INC.
Entity Type:Organization
Organization Name:ANNA MARIA OF AURORA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:C
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:330-562-6171
Mailing Address - Street 1:889 N AURORA RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202-9537
Mailing Address - Country:US
Mailing Address - Phone:330-562-6171
Mailing Address - Fax:330-562-3572
Practice Address - Street 1:889 N AURORA RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:OH
Practice Address - Zip Code:44202-9537
Practice Address - Country:US
Practice Address - Phone:330-562-6171
Practice Address - Fax:330-562-3572
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANNA MARIA OF AURORA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3081776Medicaid