Provider Demographics
NPI:1144528076
Name:CEDARS OF LEBANON NURSING & REHABILITATION CENTER, LTD
Entity type:Organization
Organization Name:CEDARS OF LEBANON NURSING & REHABILITATION CENTER, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:HERTANU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-381-5794
Mailing Address - Street 1:2120 S GREEN RD
Mailing Address - Street 2:SUITE 02
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3349
Mailing Address - Country:US
Mailing Address - Phone:216-381-5794
Mailing Address - Fax:216-381-5797
Practice Address - Street 1:102 E SILVER ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-1812
Practice Address - Country:US
Practice Address - Phone:513-932-0300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-01
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility