Organization
MONTEFIORE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAUREN B ROCK (PRESIDENT AND CEO)
(216) 360-9080
Entity
Organization
Contact information
Practice address
ONE DAVID N MYERS PARKWAY, BEACHWOOD, OH 44122
(216) 910-2641
(216) 910-2299
Mailing address
ONE DAVID N MYERS PARKWAY, BEACHWOOD, OH 44122-1162
(216) 910-2641
(216) 910-2299
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1956N
OH
332BN1400X
Nursing Facility Supplies (DME)
332BN1400X
OH
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
332BP3500X
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0025690
—
OH
01
—
0346700001
MEDICARE NSC
OH
Enumeration date
11/08/2006
Last updated
01/30/2012
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