Provider Demographics
NPI:1275919995
Name:CONTINENT HEALTH COMPANY OF CORTLAND, LLC
Entity Type:Organization
Organization Name:CONTINENT HEALTH COMPANY OF CORTLAND, LLC
Other - Org Name:CONCORD CARE CENTER OF CORTLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-207-1714
Mailing Address - Street 1:4711 GOLF RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1224
Mailing Address - Country:US
Mailing Address - Phone:847-933-9280
Mailing Address - Fax:
Practice Address - Street 1:4250 SODOM HUTCHINGS RD
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:OH
Practice Address - Zip Code:44410-9790
Practice Address - Country:US
Practice Address - Phone:330-770-7771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
36-5949OtherMEDICARE ID