Organization
EMBASSY SHENANGO VALLEY LLC
Active
Other names
Embassy of Shenango Valley
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS CICCONE (CCO)
(216) 378-2050
Entity
Organization
Contact information
Practice address
3726 E STATE ST, HERMITAGE, PA 16148-3409
(724) 342-5279
Mailing address
25201 CHAGRIN BLVD STE 190, BEACHWOOD, OH 44122-5633
(216) 378-2050
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011302
PA DOH
PA
Enumeration date
01/03/2022
Last updated
01/03/2022
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