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Organization

LIFTEDCLE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GINA N EATON (CEO)
(866) 854-3833
Entity
Organization

Contact information

Practice address
4098 E 123RD ST, CLEVELAND, OH 44105-5456
(866) 854-3833
Mailing address
4098 E 123RD ST, CLEVELAND, OH 44105-5456
(866) 854-3833

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
251B00000X
Case Management Agency
251C00000X
Developmentally Disabled Services Day Training Agency
251S00000X
Community/Behavioral Health Agency
Primary
251X00000X
Supports Brokerage Agency
253Z00000X
In Home Supportive Care Agency
320800000X
Mental Illness Community Based Residential Treatment Facility
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
332U00000X
Home Delivered Meals
342000000X
Transportation Network Company
347C00000X
Private Vehicle
347E00000X
Transportation Broker
385HR2055X
Child Mental Illness Respite Care
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care

Other

Enumeration date
10/05/2024
Last updated
12/14/2024
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