Provider Demographics
NPI:1922586650
Name:GARDEN PARK HEALTH CARE CENTER LLC
Entity Type:Organization
Organization Name:GARDEN PARK HEALTH CARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF BUSINESS OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:EITAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAGHAIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-694-7405
Mailing Address - Street 1:3536 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-2618
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3536 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-2618
Practice Address - Country:US
Practice Address - Phone:513-751-4900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-03
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1028N313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility