Provider Demographics
NPI:1942207923
Name:ANNA MARIA OF AURORA, INC.
Entity type:Organization
Organization Name:ANNA MARIA OF AURORA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:NORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-562-6171
Mailing Address - Street 1:889 N AURORA RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202-9537
Mailing Address - Country:US
Mailing Address - Phone:330-562-6171
Mailing Address - Fax:330-562-3572
Practice Address - Street 1:889 N AURORA RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:OH
Practice Address - Zip Code:44202-9537
Practice Address - Country:US
Practice Address - Phone:330-562-6171
Practice Address - Fax:330-562-3572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH173314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2420222Medicaid
OH365072Medicare ID - Type Unspecified