Organization
NORTHEAST OHIO COMMUNITY SUPPORT DAY SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EBONIE M PERKINS (CEO)
(216) 279-4118
Entity
Organization
Contact information
Practice address
1766 SUNSET DR, RICHMOND HEIGHTS, OH 44143-1245
(216) 279-4118
Mailing address
1766 SUNSET DR, RICHMOND HEIGHTS, OH 44143-1245
(216) 279-4118
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
—
—
315P00000X
Intellectual Disabilities Intermediate Care Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
05/23/2025
Last updated
05/23/2025
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