CRESTMONT NURSING HOME NORTH CORP. (NPI# 1487656773) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1487656773 |
Entity Type | Organization |
Organization Name | CRESTMONT NURSING HOME NORTH CORP. |
Other Organization Name | CRESTMONT NORTH NURSING HOME |
Practice Address |
13330 Detroit Ave Lakewood OH 44107-2850 |
Mailing Address |
24340 Sperry Dr Westlake OH 44145-1565 |
Practice Telephone | 2162289550 |
Practice Fax Number | 2165212193 |
Mailing Telephone | 4406172103 |
Mailing Fax Number | 4408352029 |
Enumeration Date | 2005-06-01 |
Last Update Date | 2008-05-30 |
Authorized Official Name | MRS. GERRY SALISBURY (OPERATIONS MANAGER) |
Authorized Official Telephone | 4406172103 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 4284 | OH | Nursing & Custodial Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OH | 0880793 | 05 |
Other Name | Type Code |
---|---|
Crestmont North Nursing Home | Doing Business As Name - Organization |
Street Address |
13330 DETROIT AVE |
City | LAKEWOOD |
State | OH |
Zip Code | 44107-2850 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801403332 | Tranquility Counseling Services LLC | Counselor | 13330 Detroit Ave, Lakewood, OH 44107-2850 | 2020-09-29 |
1770100158 | Tranquility Counseling Services LLC | Community/Behavioral Health | 13330 Detroit Ave, Lakewood, OH 44107-2850 | 2020-07-01 |
1316560337 | Christina Coley | Counselor | 13330 Detroit Ave, Lakewood, OH 44107-2850 | 2020-05-26 |
1831350610 | Crestmont Nursing Home North Corp | Clinical Medical Laboratory | 13330 Detroit Ave, Lakewood, OH 44107-2850 | 2008-06-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326522210 | Lawrence M Roth | Social Worker | 14701 Detroit Ave Ste 363, Lakewood, OH 44107 | 2018-09-18 |
1376065730 | Fareeha Khan | Internal Medicine | 12540 Edgewater Drive, Apt 411, Lakewood, OH 44107 | 2017-07-07 |
1912433756 | Julie Ann Foucher-urcuyo | Family Medicine | 14601 Detroit Ave, Fl 2, Lakewood, OH 44107 | 2017-05-11 |
1225563661 | Elizabeth Ann Rainbolt | Family Medicine | 14601 Detroit Ave Fl 2, Lakewood, OH 44107 | 2017-04-24 |
1255882551 | Kristen Murray | Dietitian, Registered | 14900 Detroit Ave Ste 207, Lakewood, OH 44107 | 2016-10-21 |
1265828131 | David Thomas Jonke | Dentist | 15640 Madison Ave., Lakewood, OH 44107 | 2015-04-08 |
1760885941 | Debra Watkins | Home Health Aide | 1510 Newman Ave Apt 406, Lakewood, OH 44107 | 2014-10-02 |
1396155198 | Monica M Owen | Occupational Therapist | 9200 Biddulph Rd., Brooklyn, OH 44107 | 2014-05-01 |
1730512229 | Marsha Elaine Favors | Licensed Practical Nurse | 1448 Lakeland Ave, Lakewood, OH 44107 | 2013-08-20 |
1508130006 | Ruth Rachel Raciniewski | Counselor | 15200 Madison Avenue, Lakewood, OH 44107 | 2012-03-01 |
Find all providers in zip 44107 |
Taxonomy Code | 313M00000X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Nursing Facility/Intermediate Care Facility |
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740699883 | Melissa | Nursing Facility/Intermediate Care Facility | 13501 Lakewood Heights Blvd Apt 5, Lakewood, OH 44107-6157 | 2014-08-02 |
1538122031 | Evergreen Terrace LLC | Nursing Facility/Intermediate Care Facility | 1625 Simms St, Lakewood, CO 80215-2611 | 2006-04-07 |
1568887479 | Azura of Lakewood | Nursing Facility/Intermediate Care Facility | 7395 W Eastman Pl, Lakewood, CO 80227-5006 | 2014-02-28 |
1063781250 | Geriatric and Family Medicine | Nursing Facility/Intermediate Care Facility | 8015 W Alameda Ave, 210, Lakewood, CO 80226-3041 | 2011-12-19 |
1285807602 | Prime Rehabilitation Services, Inc | Nursing Facility/Intermediate Care Facility | 20 13th St, Lakewood, NJ 08701-1979 | 2008-04-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730663139 | Pamela Sue Williams | Nursing Facility/Intermediate Care Facility | 1112 Wamajo Dr, Sandusky, OH 44870-4368 | 2018-09-20 |
1407363849 | Provider Services LLC | Nursing Facility/Intermediate Care Facility | 3071 Dunbarton Ave Nw, Canton, OH 44708-1818 | 2018-01-08 |
1518493683 | Melody Sue King | Nursing Facility/Intermediate Care Facility | 822 Youngs Lane, Cincinnati, OH 45245 | 2017-05-10 |
1700323631 | Mika Derifield | Nursing Facility/Intermediate Care Facility | 205 S Pardee St, Wadsworth, OH 44281-1465 | 2017-01-30 |
1336693860 | Taria Thompson | Nursing Facility/Intermediate Care Facility | 613 E 102nd St, Cleveland, OH 44108-1326 | 2016-08-13 |
1205389319 | Soamazin Automotive | Nursing Facility/Intermediate Care Facility | 14115 Maplerow Ave, Cleveland, OH 44105-6447 | 2016-07-26 |
1194198143 | Christina Laury | Nursing Facility/Intermediate Care Facility | 7666 Clovernook Ave, Cincinnati, OH 45231-3506 | 2015-11-12 |
1437539483 | Arlington Pointe Investment Group, LLC | Nursing Facility/Intermediate Care Facility | 4900 Hendrickson Road, Middletown, OH 45044 | 2015-06-04 |
1972981322 | Toward Independence Inc. | Nursing Facility/Intermediate Care Facility | 1841 Pueblo Dr, Xenia, OH 45385-4228 | 2015-05-18 |
1053799783 | Toward Independence Inc. | Nursing Facility/Intermediate Care Facility | 5021 Oaklawn Dr, Cincinnati, OH 45227-1433 | 2015-05-14 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.