Organization
AUTUMN CORPORATION
Active
Other names
Autumn Care of Statesville
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM I. WEISBERG (VICE PRESIDENT)
(216) 292-5706
Entity
Organization
Contact information
Practice address
2001 VAN HAVEN DR, STATESVILLE, NC 28625-4342
(704) 883-9700
(704) 883-9966
Mailing address
26691 RICHMOND RD, BEDFORD HEIGHTS, OH 44146-1421
(216) 292-5706
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0599
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3405511
—
NC
Enumeration date
12/15/2005
Last updated
01/21/2019
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