Organization
PARK VISTA IL OPS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHLOMO MUSHELL (MANAGER)
(917) 251-5131
Entity
Organization
Contact information
Practice address
1216 5TH AVE, YOUNGSTOWN, OH 44504-1605
(330) 746-2944
Mailing address
1216 5TH AVE, YOUNGSTOWN, OH 44504-1605
(330) 746-2944
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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