MEDICARE: EASTER SEAL SOCIETY OF NORTHWESTERN OHIO INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023150885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EASTER SEAL SOCIETY OF NORTHWESTERN OHIO INC.

Provider Business Mailing Address
First Line	:	1909 N RIDGE RD E STE 6
Second Line	:
City	:	LORAIN
State	:	OH
Zip	:	44055-3379
Country	:	US
Telephone Number	:	440-277-7337
Fax Number	:	440-277-7339

Provider Business Practice Location Address
First Line	:	1909 N RIDGE RD E STE 6
Second Line	:
City	:	LORAIN
State	:	OH
Zip	:	44055-3379
Country	:	US
Telephone Number	:	440-277-7337
Fax Number	:	440-277-7339

Authorized Official
Title or Position	:	CEO
Name	:	MS. SHEILA DUNN
Credential	:
Telephone Number	:	440-277-7337

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	08/22/2020

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