Organization
A BRAND NEW START ADULT DAY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA LYNN GORDON RN (EXECUTIVE DIRECTOROWNER)
(216) 382-2222
Entity
Organization
Contact information
Practice address
533 S GREEN RD, SOUTH EUCLID, OH 44121-2818
(440) 840-2491
(440) 878-5026
Mailing address
533 S GREEN RD, SOUTH EUCLID, OH 44121-2818
(440) 840-2491
(440) 878-5026
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
1586523
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2613523
—
OH
05
—
2650126
—
OH
05
—
2707771
—
OH
Enumeration date
03/19/2007
Last updated
08/22/2020
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