NPI 1629866439
Shane Hill Divine Opco LLC
Practice location
- Address
- 10731 State Route 118, Rockford, OH 45882-8947
- Phone
- (330) 620-7828
- Mailing address
- 5915 Landerbrook Dr STE 350, Mayfield Heights, OH 44124-4063
Authorised official
- Name
- Jeffrey Degyansky
- Title
- Chief Operating Officer
- Phone
- (330) 620-7828
Registered specialties
Assisted Living Facility
Primary
Registry record
- NPI
- 1629866439
- Entity type
- Organization
- NPI issued
- 30 Apr 2025
- Record last updated
- 30 Apr 2025
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.