Provider Demographics
NPI:1982005906
Name:GREEN VILLAGE SKILLED NURSING & REHABILITATION, LTD.
Entity Type:Organization
Organization Name:GREEN VILLAGE SKILLED NURSING & REHABILITATION, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:FRANCUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-929-0009
Mailing Address - Street 1:405 TALLMADGE RD
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-3362
Mailing Address - Country:US
Mailing Address - Phone:330-920-6472
Mailing Address - Fax:330-920-6477
Practice Address - Street 1:708 MOORE RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44319-3848
Practice Address - Country:US
Practice Address - Phone:330-409-0345
Practice Address - Fax:330-920-6477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-09
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0118995Medicaid
OH36-6425Medicare PIN