Provider Demographics
NPI:1417189796
Name:MCGREGOR AT OVERLOOK
Entity Type:Organization
Organization Name:MCGREGOR AT OVERLOOK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CONN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:216-851-8200
Mailing Address - Street 1:14900 PRIVATE DRIVE
Mailing Address - Street 2:
Mailing Address - City:EAST CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44112-3413
Mailing Address - Country:US
Mailing Address - Phone:216-851-8200
Mailing Address - Fax:216-851-6634
Practice Address - Street 1:2187 OVERLOOK RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-2323
Practice Address - Country:US
Practice Address - Phone:216-851-8200
Practice Address - Fax:216-851-6634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0736N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility