Diversicare of Avon, LLC

NPI #1891102760 in Avon, Ohio

Provider Information

NPI Number
1891102760
Entity Type
Organization
Organization Name
Diversicare of Avon, LLC
Subpart
Yes (part of a larger organization)
Parent Organization
DIVERSICARE LEASING COMPANY II, LLC
Primary Specialty
Skilled Nursing Facility
Enumeration Date
Jul 12, 2014
Last Updated
Jul 12, 2014

Practice Location

Address
32900 DETROIT RD
City
Avon
State
Ohio
ZIP Code
44011-2018
Phone
(440) 937-6201

Authorized Official

Name
KELLY J GILL
Title
PRESIDENT AND CEO
Phone
(615) 771-7575

Specialties & Taxonomy Codes

Specialty
Skilled Nursing Facility

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