Provider Demographics
NPI:1316916612
Name:SLOVENE HOME FOR THE AGED
Entity type:Organization
Organization Name:SLOVENE HOME FOR THE AGED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED NURSING HOME ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:SAS
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:216-486-0268
Mailing Address - Street 1:18621 NEFF RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44119-3018
Mailing Address - Country:US
Mailing Address - Phone:216-486-0268
Mailing Address - Fax:216-531-6976
Practice Address - Street 1:18621 NEFF RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44119-3018
Practice Address - Country:US
Practice Address - Phone:216-486-0268
Practice Address - Fax:216-531-6976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2231313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1103800001Medicare NSC