Organization
PALM CREST BELLAIRE,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN ROTENBERRY CPA (CFO)
(440) 239-4300
Entity
Organization
Contact information
Practice address
12709 BELLAIRE RD, CLEVELAND, OH 44135-4821
(216) 941-4545
(216) 941-6640
Mailing address
12709 BELLAIRE RD, CLEVELAND, OH 44135-4821
(216) 941-4545
(216) 941-6640
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3892
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0350721
—
OH
Enumeration date
06/08/2005
Last updated
08/22/2020
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