Organization
EDGEWOOD MANOR OF GREENFIELD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDER SHERMAN (MANAGING MEMBER)
(718) 688-8760
Entity
Organization
Contact information
Practice address
850 NELLIE ST, GREENFIELD, OH 45123-1567
(937) 981-2165
Mailing address
1535 ROCKAWAY PKWY, BROOKLYN, NY 11236-4001
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1389N
ODH HOME NUMBER
OH
Enumeration date
08/30/2017
Last updated
08/30/2017
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