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Organization
PEARL III LEASING CO, LLC
Active
Organization
PEARL III LEASING CO, LLC
Active
Other names
Pine Grove Habilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SANDRA K HUBBARD (DIR OF A/R)
(513) 530-1327
Entity
Organization
Contact information
Practice address
5608 PEARL RD, PARMA, OH 44129-2547
(440) 888-1320
(440) 888-1304
Mailing address
4700 ASHWOOD DR, SUITE 200, CINCINNATI, OH 45241-2465
(513) 530-1600
(513) 530-1697
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
25454
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2607129
—
OH
Enumeration date
04/04/2007
Last updated
12/18/2008
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