Provider Demographics
NPI:1417529686
Name:CENTRAL VILLAGE LTD. CO.
Entity Type:Organization
Organization Name:CENTRAL VILLAGE LTD. CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:MALANOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-989-5200
Mailing Address - Street 1:3905 OBERLIN AVE
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-2853
Mailing Address - Country:US
Mailing Address - Phone:440-989-5200
Mailing Address - Fax:866-229-7534
Practice Address - Street 1:474 CHURCH ST
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001-2206
Practice Address - Country:US
Practice Address - Phone:440-984-6999
Practice Address - Fax:866-229-7534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility