Organization
EDGEWOOD MANOR OF WELLSTON LLC
Active
Other names
Edgewood Manor of Wellston
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDER SHERMAN (MANAGING MEMBER)
(718) 688-8760
Entity
Organization
Contact information
Practice address
405 NORTH PARK AVENUE, WELLSTON, OH 45692
(740) 384-5611
Mailing address
1535 ROCKAWAY PKWY, BROOKLYN, NY 11236-4001
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225N
ODH HOME NUMBER
OH
Enumeration date
08/31/2017
Last updated
08/31/2017
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