- Enrollment id
- O20240418002924
- Enrollment state
- OH
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1548048598
- Multiple npi flag
- N
- Ccn
- 365046
- Associate id
- 2264871508
- Organization name
- DAUGHTERS OF MIRIAM CENTER FOR NURSING & REHABILITATION LLC
- Incorporation date
- 2023-12-19
- Incorporation state
- OH
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- DAUGHTERS OF MIRIAM CENTER FOR NURSING & REHABILIT
- Affiliation entity name
- THE ROSENBERG FAMILY
- Affiliation entity id
- 685
- Address line 1
- 1 DAVID MYERS PKWY
- City
- BEACHWOOD
- State
- OH
- Zip code
- 441221162