Organization
FAIRPORT ENTERPRISES, INC.
Active
Other names
THE LAURELS OF MASSILLON
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANIS KHAN (CFO)
(614) 794-8800
Entity
Organization
Contact information
Practice address
2000 SHERMAN CIR NE, MASSILLON, OH 44646-5219
(330) 830-9988
(330) 830-0039
Mailing address
8181 WORTHINGTON RD, WESTERVILLE, OH 43082-8067
(614) 794-8800
(614) 794-8826
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
2082N
OH
314000000X
Skilled Nursing Facility
Primary
2082N
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0283787
—
OH
Enumeration date
05/25/2006
Last updated
06/17/2016
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