Organization · Type 2 NPI

Summerville at Camelot Place LLC

Assisted Living Facility · Medina, OH

NPI number 1124354360 Active

Practice location

49 Leisure Ln
Medina, OH 44256-1285

Call (330) 723-5825 Map

Fax (330) 722-7039

Mailing address

3131 Elliott Ave, Suite 500
Seattle, WA 98121-1044

Specialties and licenses

Taxonomy	Code	License
Assisted Living Facility Primary	310400000X	2357R (OH)

Assisted Living Facility: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

2 other providers at this address

Other assisted living facility providers in Medina

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NPI record

NPI: 1124354360
Entity type: Organization (Type 2)
Issued: Oct 22, 2009
Last updated: Oct 22, 2009
Status: Active
Subpart: Yes of Summerville Senior Living, Inc.

Other names

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Emeritus at Camelot Place · doing business as

Authorized official

Noelle D Bickel
Licensing Specialist
(206) 298-2909

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1124354360

Summerville at Camelot Place LLC's National Provider Identifier is 1124354360, issued on Oct 22, 2009. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Medina, OH. The record was last updated on Oct 22, 2009.