Provider Demographics
NPI:1043244395
Name:ROGER'S RETIREMENT CENTER, INC.
Entity type:Organization
Organization Name:ROGER'S RETIREMENT CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:VALDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:216-851-1853
Mailing Address - Street 1:4276 MONTICELLO BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-2815
Mailing Address - Country:US
Mailing Address - Phone:216-851-1853
Mailing Address - Fax:216-851-1865
Practice Address - Street 1:4276 MONTICELLO BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-2815
Practice Address - Country:US
Practice Address - Phone:216-851-1853
Practice Address - Fax:216-851-1865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2593886OtherMRDD
OH0069352Medicaid