Organization
TAMARA M COWANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA M COWANS (STNA)
(216) 205-1093
Entity
Organization
Contact information
Practice address
9409 EASTON AVE, CLEVELAND, OH 44104-5417
(216) 205-1093
Mailing address
9409 EASTON AVE, CLEVELAND, OH 44104-5417
(216) 205-1093
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
400171191002
OH
315P00000X
Intellectual Disabilities Intermediate Care Facility
400171191002
OH
Other
Enumeration date
02/21/2014
Last updated
02/21/2014
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