Marymount Healthcare, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MARYMOUNT HEALTHCARE, LLC

Doing business as

Marymount Place

Practice address

5100 Marymount Village Dr
Garfield Heights, OH 44125-2982

Phone

(216) 332-1100

Fax

(216) 332-1742

NPI assigned

Jun 8, 2023

Last updated

Jun 8, 2023By 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

David Jakobowitch

Title

Cao

Phone

(917) 410-5283

Specialties & licenses 1

Addresses

Other names 1

• Marymount Place Doing business as

Tax ID family

Marymount Healthcare LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Marymount Healthcare, LLC

  • Skilled Nursing Facility
  • Garfield Heights, OH
  • NPI 1851085039
  NPD tax ID

Locations

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

{
    "created_epoch": "1686182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686182400000",
    "number": "1154015345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3019 AVENUE J",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112103837",
            "telephone_number": "917-410-5283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 MARYMOUNT VILLAGE DR",
            "city": "GARFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441252982",
            "telephone_number": "216-332-1100",
            "fax_number": "216-332-1742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYMOUNT HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-08",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A",
        "authorized_official_last_name": "JAKOBOWITCH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "917-410-5283"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marymount Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nefertari Marine
• Dwaine Athony Martin Sr.
• Latasha Martin
• Louis C Martin, CDCA
• Tara M Martin
• Marymount Healthcare, LLC
• Marymount Hospital (Marymount Family Pharmacy)
• Marymount Hospital Inc (Marymount Hospital)
• Marymount Hospital Inc
• Marymount Hospital Inc (Marymount Hospital)

• Assisted Living Facility in Garfield Heights, OH
• Providers in Garfield Heights, OH by specialty
• Assisted Living Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; 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.