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Organization
EMBASSY SHENANGO VALLEY LLC
Active
Organization
EMBASSY SHENANGO VALLEY LLC
Active
Other names
Embassy of Shenango Valley
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS CICCONE (CCO)
(216) 378-2050
Entity
Organization
Contact information
Practice address
3726 E STATE ST, HERMITAGE, PA 16148-3409
(724) 342-5279
Mailing address
25201 CHAGRIN BLVD STE 190, BEACHWOOD, OH 44122-5633
(216) 378-2050
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011302
PA DOH
PA
Enumeration date
01/03/2022
Last updated
01/03/2022
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