Individual
CHARLES HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9226 SAINT CLAIR AVE, CLEVELAND, OH 44108-1911
(440) 376-8152
Mailing address
9226 SAINT CLAIR AVE, CLEVELAND, OH 44108-1911
(440) 376-8152
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
347C00000X
Private Vehicle
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0307188
—
OH
Enumeration date
12/30/2020
Last updated
12/30/2020
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