Organization
SARAS HEART
Active
Other names
mikkis
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANEQUA YENAE JORDAN L.P.N. (INDEPEDENT CONTRACTOR)
(313) 808-3314
Entity
Organization
Contact information
Practice address
2320 STONEPATH ST, LORAIN, OH 44052-1189
(313) 808-3314
Mailing address
2320 STONEPATH ST, LORAIN, OH 44052-1189
(313) 808-3314
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
4703101185
MI
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
PN 115400
OH
Other
Enumeration date
02/27/2010
Last updated
02/27/2010
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