Provider Demographics
NPI:1669279907
Name:EBS SYLVANIA LLC
Entity type:Organization
Organization Name:EBS SYLVANIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK E. BRADY
Authorized Official - Middle Name:E
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-291-1223
Mailing Address - Street 1:6805 SYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-3683
Mailing Address - Country:US
Mailing Address - Phone:419-882-0029
Mailing Address - Fax:
Practice Address - Street 1:6805 SYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-3683
Practice Address - Country:US
Practice Address - Phone:419-882-0029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EBS SENIOR LIVING FUND LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility