Individual
NICOLE LA'SHAWN MANGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15626 HOLMES AVE, CLEVELAND, OH 44110-2446
(216) 598-1518
Mailing address
15626 HOLMES AVE, CLEVELAND, OH 44110-2446
(216) 598-1518
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
OH
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
OH
Other
Enumeration date
10/24/2024
Last updated
10/24/2024
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