SNF Wadsworth LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2350N Issued in OH

Legal business name

SNF WADSWORTH LLC

Doing business as

Golden Leaf Rehab & Nursing

Practice address

540 Great Oaks TRL
Wadsworth, OH 44281-8799

Phone

(330) 336-3472

Fax

(330) 334-2026

NPI assigned

Dec 18, 2006

Organization subpart

No

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

Authorized official

Name

Brian Keith McMahan

Title

Controller

Phone

(440) 498-3000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Golden Leaf Rehab & Nursing Doing business as

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598828907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5625 EMERALD RIDGE PKWY",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441391860",
            "telephone_number": "440-498-3000",
            "fax_number": "440-498-8257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 GREAT OAKS TRL",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442818799",
            "telephone_number": "330-336-3472",
            "fax_number": "330-334-2026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNF WADSWORTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCMAHAN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "440-498-3000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "2350N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2319717",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Golden Leaf Rehab & Nursing",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert Skiffey
• Robert James Skiffey, DDS
• Amy Smith
• Audriana Smith
• Stephani Smith
• Sadie-Lynn Marie Snyder
• Society for Handicapped Citizens
• Society for Handicapped Citizens
• Soul Purpose Wellness, LLC
• James Scott Spencer

• Skilled Nursing Facility in Wadsworth, OH
• Providers in Wadsworth, 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.