Provider Demographics
NPI:1629015433
Name:ALLIANCE HEALTHCARE BRAEVIEW, INC.
Entity Type:Organization
Organization Name:ALLIANCE HEALTHCARE BRAEVIEW, INC.
Other - Org Name:BRAEVIEW CARE AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ELI
Authorized Official - Middle Name:M
Authorized Official - Last Name:GUNZBURG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-658-1040
Mailing Address - Street 1:29225 CHAGRIN BLVD.
Mailing Address - Street 2:SUITE 230
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:440-658-1040
Mailing Address - Fax:866-629-9730
Practice Address - Street 1:20611 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44117
Practice Address - Country:US
Practice Address - Phone:216-486-9300
Practice Address - Fax:216-486-2603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6127313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2170709Medicaid
OH2170709Medicaid