Provider Demographics
NPI:1255863635
Name:MENTOR HEALTH AND REHABILITATION CENTER, INC.
Entity Type:Organization
Organization Name:MENTOR HEALTH AND REHABILITATION CENTER, INC.
Other - Org Name:MENTOR RIDGE HEALTH AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRENNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-292-5555
Mailing Address - Street 1:30050 CHAGRIN BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PEPPER PIKE
Mailing Address - State:OH
Mailing Address - Zip Code:44124-5716
Mailing Address - Country:US
Mailing Address - Phone:216-292-5555
Mailing Address - Fax:216-292-5511
Practice Address - Street 1:8151 NORTON PKWY
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060
Practice Address - Country:US
Practice Address - Phone:440-299-5500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-03
Last Update Date:2017-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility