Organization
CRESTMONT NURSING HOME NORTH CORP.
Active
Other names
Crestmont North Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELIAS J COURY (OWNER)
(216) 539-7846
Entity
Organization
Contact information
Practice address
13330 DETROIT AVE, LAKEWOOD, OH 44107-2850
(216) 228-9550
(216) 521-2193
Mailing address
13330 DETROIT AVE, LAKEWOOD, OH 44107-2850
(216) 539-7846
(216) 521-1212
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
4284
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0880793
—
OH
Enumeration date
06/01/2005
Last updated
10/03/2022
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