Governor'S Village

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

RCF2332R Issued in OH

Legal business name

GOVERNOR'S VILLAGE

Practice address

280 N Commons Blvd
Mayfield Village, OH 44143-1592

Phone

(440) 449-8788

NPI assigned

Jul 13, 2009

Organization subpart

No

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

Authorized official

Name

Michelle Kathleen Gorman

Title

Executive Director

Phone

(440) 449-8788

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247443200000",
    "number": "1316176266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 N COMMONS BLVD",
            "city": "MAYFIELD VILLAGE",
            "state": "OH",
            "postal_code": "441431592",
            "telephone_number": "440-449-8788",
            "fax_number": "440-442-8648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 N COMMONS BLVD",
            "city": "MAYFIELD VILLAGE",
            "state": "OH",
            "postal_code": "441431592",
            "telephone_number": "440-449-8788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOVERNOR'S VILLAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-13",
        "last_updated": "2009-07-13",
        "status": "A",
        "authorized_official_last_name": "GORMAN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "KATHLEEN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "440-449-8788"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OH",
            "license": "RCF2332R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2818455",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Fogle, MS, BCBA
• Mario Angelo Gastaldo, DPT
• Edward John Gaydos, D.O.
• Generations Care Oh, LLC
• Margie C Goldberg, LISW
• Rosemary Ann Hajdukovic
• Hanna Wang & Ezziddin MDS Inc
• Amanda Marie Hienton, CNP
• Hillcrest Pediatrics Inc.
• Danielle R Hoenig, AU.D.

• Assisted Living Facility in Mayfield Village, OH
• Providers in Mayfield Village, 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 Jul 13, 2009; 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.