Ely Park Health Care, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

4023 Issued in OH

Legal business name

ELY PARK HEALTH CARE, INC.

Doing business as

Palm Crest

Practice address

1251 East Ave
Elyria, OH 44035-7674

Phone

(440) 322-0726

Fax

(440) 322-2810

NPI assigned

Jun 8, 2005

Organization subpart

No

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

Authorized official

Name

Brian Colleran

Title

President

Phone

(440) 614-0160

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Palm Crest Doing business as

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189382400000",
    "number": "1083618060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22021 BROOKPARK RD",
            "address_2": "SUITE 123",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441263100",
            "telephone_number": "440-614-0160",
            "fax_number": "440-614-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 EAST AVE",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440357674",
            "telephone_number": "440-322-0726",
            "fax_number": "440-322-2810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELY PARK HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-08",
        "last_updated": "2007-09-10",
        "status": "A",
        "authorized_official_last_name": "COLLERAN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-614-0160"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "4023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2750670",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palm Crest",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mabelle El-Khoury, DDS
• Joel H. Elconin, MD
• Teshika Elder
• Elite Performance Physical Therapy LLC
• Pamela Parobek Eltrich, LISW-S
• Elyria Anesthesia Incorporated
• Elyria Cardiac Cath Lab, LLC
• Elyria Chiropractic Services Inc
• Elyria Chiropratic and Rehabilitation Inc
• Elyria City Schools

• Skilled Nursing Facility in Elyria, OH
• Providers in Elyria, 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 Sep 10, 2007; 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.