Healthcare Provider Details

I. General information

NPI: 1114105202
Provider Name (Legal Business Name): VISITING NURSE ASSOCIATION OF CLEVELAND HOSPICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2008
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 KEYNOTE CIR STE 300
BROOKLYN HEIGHTS OH
44131-1869
US

IV. Provider business mailing address

925 KEYNOTE CIR STE 300
BROOKLYN HEIGHTS OH
44131-1869
US

V. Phone/Fax

Practice location:
  • Phone: 216-931-1391
  • Fax: 216-694-4162
Mailing address:
  • Phone: 216-931-1391
  • Fax: 216-694-4162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number0035HSP
License Number StateOH

VIII. Authorized Official

Name: MS. RENEE ANN COUGHLIN
Title or Position: CHIEF OPERATING OFFICER
Credential: PT, DPT
Phone: 216-931-1391