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Individual

CAPRICE L MUNDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4610 GREEN RD, WARRENSVILLE HTS, OH 44128
(216) 758-1057
Mailing address
2261 EAST 73RD STREET, CLEVELAND, OH 44103
(216) 758-1057

Taxonomy

Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
251C00000X
Developmentally Disabled Services Day Training Agency
251X00000X
Supports Brokerage Agency
253Z00000X
In Home Supportive Care Agency
3747P1801X
Personal Care Attendant
Primary
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care

Other

Enumeration date
06/26/2023
Last updated
06/27/2023
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