Healthcare Provider Details

I. General information

NPI: 1487377834
Provider Name (Legal Business Name): ELDERCARE SERVICES INSTITUTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2022
Last Update Date: 09/21/2022
Certification Date: 09/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11890 FAIRHILL RD
CLEVELAND OH
44120-1053
US

IV. Provider business mailing address

11890 FAIRHILL RD
CLEVELAND OH
44120-1053
US

V. Phone/Fax

Practice location:
  • Phone: 440-241-7399
  • Fax: 216-373-1816
Mailing address:
  • Phone: 440-241-7399
  • Fax: 216-373-1816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: SHERILYN ANN OLOSKY
Title or Position: BILLING COORDINATOR
Credential:
Phone: 216-373-1616