Organization
SHANE HILL DIVINE OPCO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY DEGYANSKY (CHIEF OPERATING OFFICER)
(330) 620-7828
Entity
Organization
Contact information
Practice address
10731 STATE ROUTE 118, ROCKFORD, OH 45882-8947
(330) 620-7828
Mailing address
5915 LANDERBROOK DR STE 350, MAYFIELD HEIGHTS, OH 44124-4063
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
04/30/2025
Last updated
04/30/2025
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