Organization
EMBASSY MERCER LLC
Active
Other names
The Lakes at Jefferson
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS CICCONE (COMPLIANCE OFFICER)
(216) 378-2050
Entity
Organization
Contact information
Practice address
7271 W MARKET ST, MERCER, PA 16137-6608
(724) 704-0039
Mailing address
25201 CHAGRIN BLVD STE 190, BEACHWOOD, OH 44122-5633
(216) 378-2050
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
451510
PA DHS
PA
Enumeration date
01/07/2022
Last updated
01/07/2022
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