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Individual

GUSTENA ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
HOME HEALTH AIDE

Contact information

Practice address
575 E 102ND ST APT 1, CLEVELAND, OH 44108-1385
(216) 355-6291
Mailing address
575 E 102ND ST APT 1, CLEVELAND, OH 44108-1385
(216) 355-6291

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
137762
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
137762
HOME HEALTH AIDE
OH
Enumeration date
01/28/2012
Last updated
01/28/2012
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