Organization
CLOVERNOOK HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB STERN (SOLE MEMBER)
(734) 659-1353
Entity
Organization
Contact information
Practice address
7025 CLOVERNOOK AVE, CINCINNATI, OH 45231-5557
(513) 605-4000
(513) 522-4122
Mailing address
15 AMERICA AVE UNIT 304, LAKEWOOD, NJ 08701-4582
(732) 659-1353
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1743N
LICENSURE
OH
Enumeration date
09/17/2018
Last updated
09/17/2018
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