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Contact Information

CRESTMONT NURSING HOME NORTH CORP.
13330 DETROIT AVE
LAKEWOOD, OH44107-2850
 Phone: 216-228-9550
 Fax: 216-521-2193
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nursing Facility/Intermediate Care Facility

313M00000X A3[10] Other Nursing Facility
Indicates primary specialty

NPI Profile & details for CRESTMONT NURSING HOME NORTH CORP.

NPI Number 1487656773
LBN Legal business name CRESTMONT NURSING HOME NORTH CORP.
Authorized official ELIAS COURY - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/01/2005
Last updated 10/03/2022 - About 4 years ago
Identifiers
OH License # 4284
OH Medicaid 0880793
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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