Provider Demographics
NPI:1558017152
Name:MINERVA CENTER FOR LIVING LLC
Entity Type:Organization
Organization Name:MINERVA CENTER FOR LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AR DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MENACHEM
Authorized Official - Middle Name:
Authorized Official - Last Name:ORZEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-327-6980
Mailing Address - Street 1:50 CHESTNUT RIDGE RD STE 107
Mailing Address - Street 2:
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-1823
Mailing Address - Country:US
Mailing Address - Phone:908-327-6980
Mailing Address - Fax:
Practice Address - Street 1:1035 E LINCOLNWAY
Practice Address - Street 2:
Practice Address - City:MINERVA
Practice Address - State:OH
Practice Address - Zip Code:44657-1215
Practice Address - Country:US
Practice Address - Phone:330-868-4147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility