Individual
LANIECE RENE BENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2150 W 117TH ST, CLEVELAND, OH 44111-1641
(567) 588-0007
Mailing address
2150 W 117TH ST, CLEVELAND, OH 44111-1641
(567) 588-0007
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
1988HHN
OH
311ZA0620X
Adult Care Home Facility
1988HHN
OH
Other
Enumeration date
04/04/2024
Last updated
04/04/2024
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