Organization
MICAH CLOVERNOOK
Active
Other names
Clovernook Health Care Pavilion
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREG MILLER (CHEIF OPERATING OFFICER)
(513) 605-2700
Entity
Organization
Contact information
Practice address
7025 CLOVERNOOK AVE, CINCINNATI, OH 45231-5557
(513) 605-4000
(513) 605-2798
Mailing address
12500 REED HARTMAN HIGHWAY, SUITE 200, CINCINNATI, OH 45231
(513) 605-2700
(513) 605-2798
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1743N
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2313900
—
OH
Enumeration date
11/16/2005
Last updated
02/12/2019
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