Provider Demographics
NPI:1730334137
Name:OLMSTED MANOR RETIREMENT COMMUNITY LTD.
Entity type:Organization
Organization Name:OLMSTED MANOR RETIREMENT COMMUNITY LTD.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MROCZKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-835-1181
Mailing Address - Street 1:27420 MILL RD
Mailing Address - Street 2:
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-3190
Mailing Address - Country:US
Mailing Address - Phone:440-779-8886
Mailing Address - Fax:440-779-9569
Practice Address - Street 1:26612 CENTER RIDGE RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145
Practice Address - Country:US
Practice Address - Phone:440-250-4080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-26
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2504R310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility