Organization
MAIN STREET CARE CENTER, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK SPRENGER (EXECUTIVE VP AND CIO)
(440) 989-5200
Entity
Organization
Contact information
Practice address
500 COMMUNITY DR, AVON LAKE, OH 44012-3313
(440) 930-6600
(440) 930-1801
Mailing address
3905 OBERLIN AVE, LORAIN, OH 44053-2838
(440) 989-5200
(440) 989-5273
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2462N
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2789380
—
OH
Enumeration date
01/23/2008
Last updated
03/18/2008
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