Provider Demographics
NPI:1720386253
Name:MUNSON HEALTHCARE, INC.
Entity Type:Organization
Organization Name:MUNSON HEALTHCARE, INC.
Other - Org Name:HEATHER HILL CARE COMMUNITIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALTIERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-936-7158
Mailing Address - Street 1:6967 DEER TRAIL AVE NE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44721-2069
Mailing Address - Country:US
Mailing Address - Phone:330-936-7158
Mailing Address - Fax:
Practice Address - Street 1:12340 BASS LAKE RD
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-8327
Practice Address - Country:US
Practice Address - Phone:440-285-4040
Practice Address - Fax:440-285-7278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-08
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0052364Medicaid
OH362014Medicare Oscar/Certification