Organization
KOINONIA COMMUNITY SERVICES LLC
Active
Parent organization
KOINONIA COMMUNITY SERVICES LLC
Other names
Van Aken House
Organization subpart
Yes
Provider details
NPI number
Legal business name
KOINONIA COMMUNITY SERVICES LLC
Authorized official
MARILINA WORKMAN (DIRECTOR OF ICF)
(216) 588-8777
Entity
Organization
Contact information
Practice address
2980 VAN AKEN BLVD, CLEVELAND, OH 44120-2862
(216) 561-7415
(216) 561-0367
Mailing address
6161 OAK TREE BLVD STE 400, INDEPENDENCE, OH 44131-2581
(216) 588-8777
(216) 588-5670
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
10/18/2019
Last updated
10/18/2019
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