Provider Demographics
NPI:1487632832
Name:NORMANDY II LIMITED PARTNERSHIP
Entity Type:Organization
Organization Name:NORMANDY II LIMITED PARTNERSHIP
Other - Org Name:NORMANDY MANOR OF ROCKY RIVER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:SHULA
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:440-333-5400
Mailing Address - Street 1:22709 LAKE RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-1021
Mailing Address - Country:US
Mailing Address - Phone:440-333-5400
Mailing Address - Fax:440-356-8923
Practice Address - Street 1:22709 LAKE RD
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-1021
Practice Address - Country:US
Practice Address - Phone:440-333-5400
Practice Address - Fax:440-356-8923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-05
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0978358Medicaid
OH0978358Medicaid