Provider Demographics
NPI:1689871477
Name:OAK HILLS NURSING CENTER
Entity type:Organization
Organization Name:OAK HILLS NURSING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:GWYN
Authorized Official - Last Name:BUCHANAN
Authorized Official - Suffix:
Authorized Official - Credentials:MACCCSLP
Authorized Official - Phone:440-282-9171
Mailing Address - Street 1:32220 ELECTRIC BLVD
Mailing Address - Street 2:
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012-1826
Mailing Address - Country:US
Mailing Address - Phone:440-933-3222
Mailing Address - Fax:
Practice Address - Street 1:3650 BEAVERCREST DR
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-1710
Practice Address - Country:US
Practice Address - Phone:440-282-9171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH51993140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5199OtherSPEECH THERAPT LICENSE