MEDICARE: INNER LIGHT HOSPICE OF OHIO

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	163WH1000X	Hospice Registered Nurse

General Provider Information

NPI Number	:	1790495570
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNER LIGHT HOSPICE OF OHIO

Provider Business Mailing Address
First Line	:	4405 SILSBY RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44118-3938
Country	:	US
Telephone Number	:	216-390-7537
Fax Number	:

Provider Business Practice Location Address
First Line	:	4405 SILSBY RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44118-3938
Country	:	US
Telephone Number	:	216-390-7537
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BENYAMIN VINEBURG
Credential	:
Telephone Number	:	216-390-7537

Provider Enumeration Date	:	12/01/2022
Last Update Date	:	12/01/2022

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Directions to “INNER LIGHT HOSPICE OF OHIO ” Practice Location

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