Organization
AUTUMN COURT OPERATING COMPANY, LLC
Active
Other names
Autumn Court
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY DEGYANSKY LNHA (VICE PRESIDENT OF OPERATIONS)
(330) 620-7828
Entity
Organization
Contact information
Practice address
1925 E 4TH ST, OTTAWA, OH 45875-1540
(419) 523-4370
Mailing address
5915 LANDERBROOK DR STE 350, MAYFIELD HEIGHTS, OH 44124-4063
(330) 620-7828
(216) 428-2055
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1543N
LICENSURE
OH
Enumeration date
06/22/2020
Last updated
12/17/2024
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