Healthcare Provider Details

I. General information

NPI: 1659399509
Provider Name (Legal Business Name): BROOKLYN HEIGHTS VILLAGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 01/23/2020
Certification Date: 01/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 TUXEDO AVE
BROOKLYN HEIGHTS OH
44131-1109
US

IV. Provider business mailing address

PO BOX 21727
CLEVELAND OH
44121-0727
US

V. Phone/Fax

Practice location:
  • Phone: 216-351-3542
  • Fax: 216-749-0892
Mailing address:
  • Phone: 440-605-9117
  • Fax: 440-442-4443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MR. AARON D. FRANK
Title or Position: CLERK TREASURER
Credential:
Phone: 216-749-4300