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Organization
EMBASSY MERCER LLC
Active
Organization
EMBASSY MERCER LLC
Active
Other names
The Lakes at Jefferson
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS CICCONE (COMPLIANCE OFFICER)
(216) 378-2050
Entity
Organization
Contact information
Practice address
7271 W MARKET ST, MERCER, PA 16137-6608
(724) 704-0039
Mailing address
25201 CHAGRIN BLVD STE 190, BEACHWOOD, OH 44122-5633
(216) 378-2050
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
451510
PA DHS
PA
Enumeration date
01/07/2022
Last updated
01/07/2022
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