Organization
SELFRIDGE LEASING, LLC
Active
Other names
Valley Oaks Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELI M. GUNZBURG MBA, LNHA (MANAGING MEMBER)
(440) 658-1040
Entity
Organization
Contact information
Practice address
500 SELFRIDGE STREET, EAST LIVERPOOL, OH 43924
(330) 385-5001
(866) 629-9730
Mailing address
29225 CHAGRIN BLVD., SUITE 230, CLEVELAND, OH 44122
(440) 658-1040
(866) 629-9730
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
—
OH
313M00000X
Nursing Facility/Intermediate Care Facility
—
—
314000000X
Skilled Nursing Facility
Primary
—
OH
314000000X
Skilled Nursing Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0058723
—
OH
01
—
366306
MEDICARE CCN
OH
Enumeration date
11/30/2011
Last updated
08/17/2015
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