Organization
VAN GORDER MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE LEE WAGNER (OWNER/OPERATOR)
(440) 946-5213
Entity
Organization
Contact information
Practice address
37819 EUCLID AVE, WILLOUGHBY, OH 44094-5900
(440) 946-5213
(440) 942-0244
Mailing address
37819 EUCLID AVE, WILLOUGHBY, OH 44094-5900
(440) 946-5213
(440) 942-0244
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
1954
OH
Other
Enumeration date
05/27/2008
Last updated
05/27/2008
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