Provider Demographics
NPI:1215051339
Name:NORTHEAST CARE CENTER, INC.
Entity type:Organization
Organization Name:NORTHEAST CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MILO
Authorized Official - Middle Name:
Authorized Official - Last Name:ABERCROMBIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-582-3300
Mailing Address - Street 1:12627 YORK RD
Mailing Address - Street 2:
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-3616
Mailing Address - Country:US
Mailing Address - Phone:440-582-3300
Mailing Address - Fax:440-582-1980
Practice Address - Street 1:12627 YORK RD
Practice Address - Street 2:
Practice Address - City:NORTH ROYALTON
Practice Address - State:OH
Practice Address - Zip Code:44133-3616
Practice Address - Country:US
Practice Address - Phone:440-582-3300
Practice Address - Fax:440-582-1980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities