Provider Demographics
NPI: | 1710383880 |
---|---|
Name: | DIPLOMAT HEALTHCARE |
Entity type: | Organization |
Organization Name: | DIPLOMAT HEALTHCARE |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | DIRECTOR OF REHAB |
Authorized Official - Prefix: | |
Authorized Official - First Name: | PATRICIA |
Authorized Official - Middle Name: | HELEN |
Authorized Official - Last Name: | KRZYWICKI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LPT |
Authorized Official - Phone: | 440-237-3104 |
Mailing Address - Street 1: | 9001 W 130TH ST |
Mailing Address - Street 2: | |
Mailing Address - City: | NORTH ROYALTON |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 44133-1011 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 440-237-3104 |
Mailing Address - Fax: | 440-237-6730 |
Practice Address - Street 1: | 9001 W 130TH STREET |
Practice Address - Street 2: | |
Practice Address - City: | NORTH ROYALTON |
Practice Address - State: | OH |
Practice Address - Zip Code: | 44133 |
Practice Address - Country: | US |
Practice Address - Phone: | 440-237-3104 |
Practice Address - Fax: | 440-237-6730 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2014-11-17 |
Last Update Date: | 2014-11-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
OH | PT2342 | 314000000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 314000000X | Nursing & Custodial Care Facilities | Skilled Nursing Facility |