Organization
ELY PARK HEALTH CARE, INC.
Active
Other names
Palm Crest
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN COLLERAN (PRESIDENT)
(440) 614-0160
Entity
Organization
Contact information
Practice address
1251 EAST AVE, ELYRIA, OH 44035-7674
(440) 322-0726
(440) 322-2810
Mailing address
22021 BROOKPARK RD, SUITE 123, FAIRVIEW PARK, OH 44126-3100
(440) 614-0160
(440) 614-0168
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
4023
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2750670
—
OH
Enumeration date
06/08/2005
Last updated
09/10/2007
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