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Organization

WILLOW PARK CONVALESCENT HOME,INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ADAM J WHITE MBA (AR MANAGER)
(614) 416-2638
Entity
Organization

Contact information

Practice address
18810 HARVARD AVE, CLEVELAND, OH 44122-6848
(216) 752-3600
(216) 752-5612
Mailing address
18810 HARVARD AVE, CLEVELAND, OH 44122-6848
(216) 752-3600
(216) 752-5612

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
4104
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2402519
OH
Enumeration date
06/09/2005
Last updated
08/22/2020
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