Provider Demographics
NPI:1275208894
Name:MINERAL RIDGE SKILLED NURSING AND RESIDENTIAL CARE, LLC
Entity Type:Organization
Organization Name:MINERAL RIDGE SKILLED NURSING AND RESIDENTIAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-772-1105
Mailing Address - Street 1:5990 VENTURE DR STE A
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-2273
Mailing Address - Country:US
Mailing Address - Phone:216-772-1105
Mailing Address - Fax:
Practice Address - Street 1:3379 MAIN ST
Practice Address - Street 2:
Practice Address - City:MINERAL RIDGE
Practice Address - State:OH
Practice Address - Zip Code:44440-8800
Practice Address - Country:US
Practice Address - Phone:330-652-9901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MINERAL RIDGE SKILLED NURSING AND RESIDENTIAL CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)