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Organization

CARE ASSISTED LIVING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DEBRA R HART DIRECTOR (CEO)
(216) 246-5590
Entity
Organization

Contact information

Practice address
15726 HOLMES AVE, CLEVELAND, OH 44110-2448
(216) 249-5590
(216) 862-5211
Mailing address
11470 EUCLID AVE STE 258, CLEVELAND, OH 44106-3934
(216) 249-5590
(216) 862-5211

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
1818779
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0075796
OH
Enumeration date
07/29/2013
Last updated
07/29/2013
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