Organization
CHARLES S. BOGAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES STEVEN BOGAN (LICENSED PRACTICAL NURSE)
(216) 804-6678
Entity
Organization
Contact information
Practice address
4656 WALFORD RD, APARTMENT 114, WARRENSVILLE HEIGHTS, OH 44128-7153
(216) 804-6678
Mailing address
4656 WALFORD RD, APARTMENT 114, WARRENSVILLE HEIGHTS, OH 44128-7153
(216) 804-6678
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
PN.127610
OH
3140N1450X
Pediatric Skilled Nursing Facility
Primary
PN.127610
OH
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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