Organization
GREATER STRIDES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER LYNN UNDERWOOD-SULLIVAN (CEO)
(440) 350-9597
Entity
Organization
Contact information
Practice address
112 HAMPSHIRE CV, PAINESVILLE, OH 44077-1380
(440) 350-9597
(440) 350-9597
Mailing address
112 HAMPSHIRE CV, PAINESVILLE, OH 44077-1380
(440) 350-9597
(440) 350-9597
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2706423
—
OH
01
—
4301375
ODMRDD CONTRACT NUMBER
OH
Enumeration date
01/02/2007
Last updated
08/22/2020
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