3660 Greentree Leasing, LLC

Key facts

NPI

1700370640

Entity type

Organization (NPI type 2)

Primary specialty

Skilled Nursing Facility 314000000X

License

2758N (OH)

Legal business name

3660 GREENTREE LEASING, LLC

Practice address

3660 Greentree Ave SW
Canton, OH 44706-4024

Phone

(330) 484-5888

Fax

(330) 484-5246

NPI assigned

Jun 14, 2018

Organization subpart

No

Authorized official

Name

Eli M. Gunzburg

Title

Manager

Phone

(216) 367-1214

National Provider Directory

Specialties & licenses

Addresses

Other names

• The Lodge at New Dawn Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 14, 2018.

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528934400000",
    "number": "1700370640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29225 CHAGRIN BLVD STE 230",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441224632",
            "telephone_number": "216-367-1214",
            "fax_number": "866-629-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 GREENTREE AVE SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447064024",
            "telephone_number": "330-484-5888",
            "fax_number": "330-484-5246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "3660 GREENTREE LEASING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-14",
        "last_updated": "2018-06-14",
        "status": "A",
        "authorized_official_last_name": "GUNZBURG",
        "authorized_official_first_name": "ELI",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "216-367-1214"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "2758N",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Lodge at New Dawn",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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