Provider Demographics
NPI:1396215976
Name:TWINSBURG HEALTHCARE CENTER LLC
Entity Type:Organization
Organization Name:TWINSBURG HEALTHCARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:J. GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:ROOF
Authorized Official - Suffix:
Authorized Official - Credentials:NHA, HSE
Authorized Official - Phone:330-540-5475
Mailing Address - Street 1:9928 VAIL DR.
Mailing Address - Street 2:
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087
Mailing Address - Country:US
Mailing Address - Phone:330-405-6040
Mailing Address - Fax:330-405-6041
Practice Address - Street 1:9928 VAIL DR.
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087
Practice Address - Country:US
Practice Address - Phone:330-405-6040
Practice Address - Fax:330-405-6041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========OtherEIN #