Provider Demographics
NPI:1366203341
Name:FAIRLAWN OPCO, LLC
Entity type:Organization
Organization Name:FAIRLAWN OPCO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LLC MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:A
Authorized Official - Last Name:FLASHNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-819-3351
Mailing Address - Street 1:575 S CLEVELAND MASSILLON RD
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3019
Mailing Address - Country:US
Mailing Address - Phone:330-666-5866
Mailing Address - Fax:330-666-3215
Practice Address - Street 1:575 S CLEVELAND MASSILLON RD
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-3019
Practice Address - Country:US
Practice Address - Phone:330-666-5866
Practice Address - Fax:330-666-3215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility