Organization · Type 2 NPI

Oak Grove Manor Operating Company LLC

Skilled Nursing Facility · Mansfield, OH

NPI number 1174149504 Active

Practice location

1670 Crider Rd
Mansfield, OH 44903-9268

Call (419) 589-6222 Map

Mailing address

5915 Landerbrook Dr Ste 350
Mayfield Heights, OH 44124-4063

Specialties and licenses

Taxonomy	Code	License
Skilled Nursing Facility Primary	314000000X	None listed

Skilled Nursing Facility: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

4 other providers at this address

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NPI record

NPI: 1174149504
Entity type: Organization (Type 2)
Issued: Jun 22, 2020
Last updated: Dec 17, 2024
Status: Active

Other names

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Oak Grove Manor · doing business as
Oak Grove Manor · doing business as

Authorized official

Mr. Jeffrey Degyansky, LNHA
Vice President of Operations
(330) 620-7828

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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 1174149504

Oak Grove Manor Operating Company LLC's National Provider Identifier is 1174149504, issued on Jun 22, 2020. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Mansfield, OH. The record was last updated on Dec 17, 2024.