Provider Demographics
NPI:1457362626
Name:MENTOR WAY NURSING & REHABILITATION CENTER, INC.
Entity Type:Organization
Organization Name:MENTOR WAY NURSING & REHABILITATION CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:FLUHART
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:440-255-9309
Mailing Address - Street 1:8881 SCHAEFFER ST
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-5035
Mailing Address - Country:US
Mailing Address - Phone:440-255-9309
Mailing Address - Fax:440-205-9120
Practice Address - Street 1:8881 SCHAEFFER ST
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-5035
Practice Address - Country:US
Practice Address - Phone:440-255-9309
Practice Address - Fax:440-205-9120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5990314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2224686Medicaid
OH366015Medicare Oscar/Certification