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Organization

AJ SUBURBAN PAVILION OPCO LLC

Active
Other names
Suburban Pavilion
Organization subpart
No

Provider details

NPI number
Authorized official
HAYLEY B WILLIAMS (ATTORNEY)
(216) 706-3936
Entity
Organization

Contact information

Practice address
20265 EMERY RD, NORTH RANDALL, OH 44128-4122
(216) 475-8880
(216) 587-4806
Mailing address
555 ANTHONY WAYNE TRL, WATERVILLE, OH 43566-1516
(216) 475-8880
(216) 587-4806

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1373N
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1373N
OHIO DEPARTMENT OF HEALTH
OH
Enumeration date
03/20/2018
Last updated
04/26/2018
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