Organization
BRENTWOOD ASSISTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT CLASSEN (PRESIDENT)
(330) 468-2273
Entity
Organization
Contact information
Practice address
915 W AURORA RD, SAGAMORE HILLS, OH 44067-1605
(330) 468-2273
(330) 468-0753
Mailing address
915 W AURORA RD, SAGAMORE HILLS, OH 44067-1605
(330) 468-2273
(330) 468-0753
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
311500000X
Alzheimer Center (Dementia Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0313053
—
OH
Enumeration date
10/02/2018
Last updated
10/02/2018
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