Provider Demographics
NPI:1578566782
Name:HOLANDER HOUSE, LTD
Entity Type:Organization
Organization Name:HOLANDER HOUSE, LTD
Other - Org Name:HOLANDER HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/SALEM HEALTHCARE MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-332-1588
Mailing Address - Street 1:1985 EAST PERSHING STREET
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-0000
Mailing Address - Country:US
Mailing Address - Phone:330-332-1588
Mailing Address - Fax:330-332-3119
Practice Address - Street 1:1985 EAST PERSHING STREET
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-0000
Practice Address - Country:US
Practice Address - Phone:330-332-1588
Practice Address - Fax:330-332-3119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1140-N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4643040001OtherDMERC REGION B CARRIER #
OH4643040001OtherDMERC REGION B CARRIER #