Provider Demographics
NPI:1740414960
Name:KEMPER HOUSE OLMSTED FALLS
Entity Type:Organization
Organization Name:KEMPER HOUSE OLMSTED FALLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:HABORAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-235-5500
Mailing Address - Street 1:25880 ELM ST
Mailing Address - Street 2:
Mailing Address - City:OLMSTED FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44138-1614
Mailing Address - Country:US
Mailing Address - Phone:440-235-5500
Mailing Address - Fax:440-235-5850
Practice Address - Street 1:25880 ELM ST
Practice Address - Street 2:
Practice Address - City:OLMSTED FALLS
Practice Address - State:OH
Practice Address - Zip Code:44138-1614
Practice Address - Country:US
Practice Address - Phone:440-235-5500
Practice Address - Fax:440-235-5850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5957311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)