Individual
TIFFANY ALLEN ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
STNA
Contact information
Practice address
10808 CHURCHILL AVE, CLEVELAND, OH 44106-1211
(216) 323-0646
Mailing address
409 W GRACE ST, BEDFORD, OH 44146-3256
(216) 323-0646
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
038232
OH
376K00000X
Nurse's Aide
Primary
321476071197
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
038232
CLASS 2 RESIDENTIAL CARE FACILITY
OH
Enumeration date
03/16/2022
Last updated
03/16/2022
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