Embassy Shenango Valley LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

EMBASSY SHENANGO VALLEY LLC

Doing business as

Embassy of Shenango Valley

Practice address

3726 E State St
Hermitage, PA 16148-3409

Phone

(724) 342-5279

NPI assigned

Jan 3, 2022

Organization subpart

No

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

Authorized official

Name

Nicholas Ciccone

Title

Cco

Phone

(216) 378-2050

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Embassy of Shenango Valley Doing business as

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

{
    "created_epoch": "1641168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641168000000",
    "number": "1881355816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25201 CHAGRIN BLVD STE 190",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225633",
            "telephone_number": "216-378-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3726 E STATE ST",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "161483409",
            "telephone_number": "724-342-5279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBASSY SHENANGO VALLEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-03",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A",
        "authorized_official_last_name": "CICCONE",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "CCO",
        "authorized_official_telephone_number": "216-378-2050"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA DOH",
            "identifier": "011302",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Embassy of Shenango Valley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Hermitage, PA
• Providers in Hermitage, PA by specialty
• Skilled Nursing Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.