Provider Demographics
NPI:1881828853
Name:S GENERATION CENTER INC
Entity Type:Organization
Organization Name:S GENERATION CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:NSONG
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:440-205-2222
Mailing Address - Street 1:8370 MUNSON RD
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-2409
Mailing Address - Country:US
Mailing Address - Phone:440-205-2222
Mailing Address - Fax:
Practice Address - Street 1:8370 MUNSON RD
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-2409
Practice Address - Country:US
Practice Address - Phone:440-205-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH106071003261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH106071003OtherOHIO DEPARTMENT OF AGING (PASSPORT PROVIDER)