# ST AUGUSTINE MANOR

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ST AUGUSTINE MANOR
- **Other names:** ST AUGUSTINE MANOR PROFESSIONAL SERVICES
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1033599105
- **Legal business name:** ST AUGUSTINE MANOR
- **Authorized official:** MR. FRANCIS S HUBA (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (216) 634-7555

## Contact information

- **Practice address:** 7801 DETROIT AVE, CLEVELAND, OH 44102-2813
- **Practice address phone:** (216) 634-7400
- **Practice address fax:** (216) 634-7483
- **Mailing address:** 7801 DETROIT AVE, CLEVELAND, OH 44102-2813
- **Mailing address phone:** (216) 634-7400
- **Mailing address fax:** (216) 634-7483

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LG0600X | Gerontology Nurse Practitioner | — | NULL | Yes |
| 363LG0600X | Gerontology Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/04/2015
- **Last updated:** 06/04/2015