Organization
PARK HAVEN INC
Active
Other names
Park Haven Home
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BEATRICE A KNOWLSON RN/LNHA (OWNER)
(440) 992-8387
Entity
Organization
Contact information
Practice address
4533 PARK AVE, ASHTABULA, OH 44004-6930
(440) 992-9441
(440) 992-7592
Mailing address
2125 W PROSPECT RD, ASHTABULA, OH 44004-6439
(440) 992-8387
(440) 992-7650
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
6091
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0242553
—
OH
Enumeration date
05/26/2006
Last updated
08/22/2020
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