Provider Demographics
NPI:1629233929
Name:FALLING WATER RETIREMENT COMMUNITY INC.
Entity Type:Organization
Organization Name:FALLING WATER RETIREMENT COMMUNITY INC.
Other - Org Name:CYRSTAL WATERS RETIREMENT COMMUNITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:COURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-243-5668
Mailing Address - Street 1:2 BEREA COMMONS
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:BEREA
Mailing Address - State:OH
Mailing Address - Zip Code:44017-2500
Mailing Address - Country:US
Mailing Address - Phone:440-243-5668
Mailing Address - Fax:440-243-3049
Practice Address - Street 1:18960 FALLING WATER RD
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-4233
Practice Address - Country:US
Practice Address - Phone:440-238-3600
Practice Address - Fax:440-238-4920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2334R310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility