Organization
HEATHER KNOLL RETIREMENT VILLAGE INC
Active
Other names
Heather Knoll of Summit County
Organization subpart
No
Provider details
NPI number
Authorized official
MARK A SPRENGER (EXECUTIVE VP AND CIO)
(440) 989-5234
Entity
Organization
Contact information
Practice address
1134 NORTH AVE, TALLMADGE, OH 44278-1065
(330) 688-8600
(330) 688-8495
Mailing address
1134 NORTH AVE, TALLMADGE, OH 44278-1065
(330) 688-8600
(330) 688-8495
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
5582
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2590352
—
OH
01
—
341904757003
MEDICAL MUTUAL
OH
01
—
BC000000M89
ANTHEM
—
Enumeration date
10/26/2005
Last updated
01/22/2008
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