Provider Demographics
NPI:1225446321
Name:DEMER RETAIL VENTURES MH, LLC
Entity Type:Organization
Organization Name:DEMER RETAIL VENTURES MH, LLC
Other - Org Name:MASSAGE HEIGHTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ADRIAN
Authorized Official - Last Name:DEMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-408-1054
Mailing Address - Street 1:3505 WESTGATE
Mailing Address - Street 2:D416
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-1331
Mailing Address - Country:US
Mailing Address - Phone:440-973-8627
Mailing Address - Fax:
Practice Address - Street 1:3505 WESTGATE
Practice Address - Street 2:D416
Practice Address - City:FAIRVIEW PARK
Practice Address - State:OH
Practice Address - Zip Code:44126-1331
Practice Address - Country:US
Practice Address - Phone:440-973-8627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-01
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit