EMBASSY WILLOW PARK LLC (NPI# 1700295573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700295573 |
| Entity Type | Organization |
| Organization Name | EMBASSY WILLOW PARK LLC |
| Other Organization Name | WILLOW PARK CONVALESCENT HOME |
| Practice Address |
18810 Harvard Ave Cleveland OH 44122-6848 |
| Mailing Address |
24579 Broadway Ave Oakwood Village OH 44146-6338 |
| Practice Telephone | 2167523600 |
| Practice Fax Number | 2167525612 |
| Mailing Telephone | 4404397976 |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2014-08-06 |
| Authorized Official Name | HAYLEY B WILLIAMS (ATTORNEY) |
| Authorized Official Telephone | 2167063936 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 1319N | OH | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Willow Park Convalescent Home | Doing Business As Name - Organization |
| Street Address |
18810 HARVARD AVE |
| City | CLEVELAND |
| State | OH |
| Zip Code | 44122-6848 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194729038 | Willow Park Convalescent Home,inc. | Skilled Nursing Facility | 18810 Harvard Ave, Cleveland, OH 44122-6848 | 2005-06-09 |
| 1437303484 | Orion Willow Park LLC | Clinical Medical Laboratory | 18810 Harvard Ave, Cleveland, OH 44122-6848 | 2008-11-04 |
| 1669635736 | Orion Willow Park LLC | Durable Medical Equipment & Medical Supplies | 18810 Harvard Ave, Cleveland, OH 44122-6848 | 2008-07-08 |
| 1972794055 | Orion Willow Park LLC | Skilled Nursing Facility | 18810 Harvard Ave, Cleveland, OH 44122-6848 | 2007-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760083174 | Sophia Denise Moncrieffe-jordan | Nurse Practitioner | 23511 Chargin Blvd, Apt. E312, Beachwood, OH 44122 | 2020-11-03 |
| 1447864400 | Resilient Bodies LLC | Massage Therapist | 24300 Chagrin Blvd #312, Beachwood, OH 44122 | 2020-09-06 |
| 1215576087 | Hni Emergency Services of Ohio, LLC | Nurse Practitioner | 22501 Chagrin Blvd, Beachwood, OH 44122 | 2019-12-27 |
| 1013555648 | Barbara L Ekelman Phd Inc | Psychologist | 24100 Chagrin Blvd, Suite 385, Beachwood, OH 44122 | 2019-12-13 |
| 1417599770 | Janise Moore | Technician | 19600 Gladstone Rd, Warrensville Hts, OH 44122 | 2019-10-08 |
| 1598312704 | Nizar Andria | Student in an Organized Health Care Education/Training Program | Cedar Rd 27050, Apartment 515, Beachwood, OH 44122 | 2019-08-22 |
| 1437703998 | Malinda Ann Davis | Social Worker | 20600 Chagrin Blvd Suite 320, Shaker Heights, OH 44122 | 2019-08-01 |
| 1891265864 | Karlan Champagne | Case Management | 23215 Commerence Park, 306, Beachwood, OH 44122 | 2018-12-03 |
| 1952896565 | Donna Pinkney | Counselor | 20550 University Blvd Apt 206, Shaker Hts, OH 44122 | 2018-06-26 |
| 1255825857 | Elizabeth Anne Donathan | Registered Nurse | 4100 Warrensville Center Rd Ste 101, Warrensville Heights, OH 44122 | 2018-06-18 |
| Find all providers in zip 44122 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700239894 | Tyler Joseph Gajdos | Skilled Nursing Facility | 4398 W 19th St, Cleveland, OH 44109-3638 | 2016-07-13 |
| 1720494495 | Tayler Cade | Skilled Nursing Facility | 1435 Clermont Rd, Cleveland, OH 44110-2806 | 2014-07-02 |
| 1619315884 | Genesis Rehab | Skilled Nursing Facility | 520 E 103rd St, Cleveland, OH 44108-1330 | 2013-06-11 |
| 1134306012 | Tri-med Pharmacy Services, LLC #3 | Skilled Nursing Facility | 2195 Varnell Rd Sw, Cleveland, TN 37311-7347 | 2008-01-23 |
| 1508057456 | Lp Cleveland LLC | Skilled Nursing Facility | 2750 Executive Park Nw, Cleveland, TN 37312-2722 | 2007-08-06 |
| 1770602435 | Dynamic Cleveland Operating Company LLC | Skilled Nursing Facility | 200 N Martin Luther King Dr, Cleveland, MS 38732-2821 | 2007-03-27 |
| 1396883591 | St Augustine Manor | Skilled Nursing Facility | 7801 Detroit Avenue, Cleveland, OH 44102 | 2007-02-01 |
| 1902958267 | Fairview Village Retirement Community, Ltd | Skilled Nursing Facility | 4110 Rocky River Dr, Cleveland, OH 44135-1175 | 2007-01-17 |
| 1376600098 | Hilo Medical Investors Ltd. | Skilled Nursing Facility | 3001 Keith St Nw, Cleveland, TN 37312-3713 | 2007-01-02 |
| 1891860656 | Cleveland Nursing and Rehabilitation Center, LLC | Skilled Nursing Facility | 4036 Highway 8 East, Cleveland, MS 38732 | 2006-11-21 |
| Find all providers in CLEVELAND | ||||
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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.