Organization
GREENS NURSING AND ASSISTED LIVING, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARILYN A. WEAVER (ASSISTANT SECRETARY)
(502) 596-7300
Entity
Organization
Contact information
Practice address
1575 BRAINARD RD, LYNDHURST, OH 44124-3096
(440) 460-1000
(440) 646-0100
Mailing address
680 S 4TH ST, LOUISVILLE, KY 40202-2407
(502) 596-7301
(502) 596-4134
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
5241
OH
314000000X
Skilled Nursing Facility
Primary
5241
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000156869
ANTHEM BLUE CROSS/ BLUE S
OH
05
—
27-58332
—
OH
Enumeration date
08/26/2005
Last updated
10/18/2017
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