Provider Demographics
NPI:1114583499
Name:ROSE-MARY, THE JOHANNA GRASSELLI REHABILITATION AND EDUCATION CENTER
Entity Type:Organization
Organization Name:ROSE-MARY, THE JOHANNA GRASSELLI REHABILITATION AND EDUCATION CENTER
Other - Org Name:ROSE-MARY CEDAR HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-481-4823
Mailing Address - Street 1:2346 W 14TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-3613
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:29400 CEDAR RD
Practice Address - Street 2:
Practice Address - City:PEPPER PIKE
Practice Address - State:OH
Practice Address - Zip Code:44124-4408
Practice Address - Country:US
Practice Address - Phone:216-481-4823
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROSE-MARY, THE JOHANNA GRASSELLI REHABILITATION AND EDUCATION CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-13
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities