Individual
VICTORIA ALEXANDRIA VICKERSTAFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12110 LEEILA AVE, CLEVELAND, OH 44135-4720
(216) 484-3209
Mailing address
12110 LEEILA AVE, CLEVELAND, OH 44135-4720
(216) 484-3209
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
OH
261QH0100X
Health Service Clinic/Center
—
OH
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
OH
331L00000X
Blood Bank
—
OH
332BN1400X
Nursing Facility Supplies (DME)
—
OH
332BX2000X
Oxygen Equipment & Supplies (DME)
—
OH
347E00000X
Transportation Broker
—
OH
373H00000X
Day Training/Habilitation Specialist
Primary
—
OH
374U00000X
Home Health Aide
—
OH
376K00000X
Nurse's Aide
—
OH
385H00000X
Respite Care
—
OH
Other
Enumeration date
10/03/2025
Last updated
10/03/2025
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