# EMBASSY PARK AVENUE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Embassy of Park Avenue
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760099311
- **Authorized official:** GEORGE REPCHICK (PRESIDENT OF MANAGER)
- **Authorized official phone:** (216) 378-2050

## Contact information

- **Practice address:** 14714 PARK AVENUE EXT, MEADVILLE, PA 16335-9400
- **Practice address phone:** (814) 337-4228
- **Mailing address:** 25201 CHAGRIN BLVD, BEACHWOOD, OH 44122-5600

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 09/28/2020
- **Last updated:** 09/28/2020