Organization
LOSKO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAMILLE TRAMIA YOUNG (CHIEF OPERATING OFFICER)
(216) 854-4424
Entity
Organization
Contact information
Practice address
1639 E 77TH ST, CLEVELAND, OH 44103-4182
(216) 854-4424
Mailing address
1639 E 77TH ST, CLEVELAND, OH 44103-4182
(216) 854-4424
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
310400000X
Assisted Living Facility
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
311Z00000X
Custodial Care Facility
—
—
311ZA0620X
Adult Care Home Facility
—
—
332U00000X
Home Delivered Meals
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
04/22/2018
Last updated
05/31/2019
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