Kethley House @ Benjamin Rose Place

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0675 Issued in OH

Legal business name

KETHLEY HOUSE @ BENJAMIN ROSE PLACE

Practice address

11900 Fairhill Rd
Cleveland, OH 44120-1053

Phone

(216) 795-5450

Fax

(216) 795-1178

NPI assigned

Sep 23, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Mary S. Marita, L.N.H.A.

Title

Administrator

Phone

(216) 373-1807

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Judith H Verba LCSW3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Benjamin Rose Institute

  • Clinical Social Worker
  • Cleveland, OH
  • NPI 1609792811
  NPD tax ID
• Eldercare Services Institute,LLC

  • Clinical Social Worker
  • Cleveland, OH
  • NPI 1689799561
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083600118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11900 FAIRHILL RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441201053",
            "telephone_number": "216-795-5450",
            "fax_number": "216-795-1178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 FAIRHILL RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441201053",
            "telephone_number": "216-795-5450",
            "fax_number": "216-795-1178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETHLEY HOUSE @ BENJAMIN ROSE PLACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARITA",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "216-373-1807",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "L.N.H.A."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "0675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2005912",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Marie Kesterson, CNS APRN-B
• Julie Lynn Kestler
• Todd Michael Kestranek Jr., PA-C
• Damian Keter
• Kristy Jo Kethe Dozier, CRNA, MNA
• Youness Kettani, PA-C
• Valerie Arslanian Kette, APRN-CRNA
• Brennan Ketteler
• Patricia S Kettren, RN BC
• Jeffrey M Ketz, PHARMD

• Skilled Nursing Facility in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.