Organization
LANTERN OF SAYBROOK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NESIAN MAKESH OTR/L, MBA (CEO)
(440) 261-3100
Entity
Organization
Contact information
Practice address
3720 NORTH RIDGE ROAD WEST, ASHTABULA, OH 44004
(440) 261-3100
(440) 992-0416
Mailing address
3720 NORTH RIDGE ROAD WEST, ASHTABULA, OH 44004
(440) 261-3100
(440) 992-0416
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
2744R
OH
Other
Enumeration date
10/25/2016
Last updated
10/25/2016
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