| Old River Associates Llc | |
|
19035 Old Detroit Rd Ste 201 Rocky River OH 44116-1750 | |
| (440) 668-5496 | |
| Not Available |
| Full Name | Old River Associates Llc |
|---|---|
| Speciality | Social Worker |
| Location | 19035 Old Detroit Rd Ste 201, Rocky River, Ohio |
| Authorized Official Name and Position | Michael J Nassif (TAX ID OWNER) |
| Authorized Official Contact | 4406685496 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Old River Associates Llc 19035 Old Detroit Rd Ste 201 Rocky River OH 44116-1750 Ph: (440) 668-5496 | Old River Associates Llc 19035 Old Detroit Rd Ste 201 Rocky River OH 44116-1750 Ph: (440) 668-5496 |
| NPI Number | 1942785233 |
|---|---|
| Provider Enumeration Date | 10/02/2018 |
| Last Update Date | 04/10/2019 |
| Medicare PECOS PAC ID | 3971846924 |
|---|---|
| Medicare Enrollment ID | O20190515001852 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942785233 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Michael J Nassif |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811308067 PECOS PAC ID: 4789994476 Enrollment ID: I20151109002391 |
| Provider Name | Elizabeth R Anthony |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609499888 PECOS PAC ID: 7214300458 Enrollment ID: I20230308002764 |
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