Hall Of Fame Divine Opco LLC
Skilled Nursing Facility in Canton, OH. Organization (NPI-2).
NPI number1831987635
StatusActive
Last updated in NPPESApr 30, 2025
Details
- NPI
- 1831987635
- Entity type
- Organization (NPI-2)
- Legal business name
- Hall Of Fame Divine Opco LLC
- Organization subpart
- No
- Enumeration date
- Apr 30, 2025
- Certification date
- Apr 30, 2025
- Last updated
- Apr 30, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | – | – | Yes |
Practice location
2714 13th St NwCanton, OH 44708-3121
Phone 330-620-7828
Mailing address
5915 Landerbrook Dr Ste 350Mayfield Heights, OH 44124-4063
Authorized official
Jeffrey Degyansky
Vp Of Operations
3306207828
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