Healthcare Provider Details

I. General information

NPI: 1023095528
Provider Name (Legal Business Name): VNA OF CLEVELAND HOSPICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 EAST 22 STREET VNA OF CLEVELAND HOSPICE
CLEVELAND OH
44115
US

IV. Provider business mailing address

2500 EAST 22 STREET VNA OF CLEVELAND HOSPICE
CLEVELAND OH
44115
US

V. Phone/Fax

Practice location:
  • Phone: 216-931-1450
  • Fax: 216-694-6355
Mailing address:
  • Phone: 216-931-1450
  • Fax: 216-694-6355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number0035HSP
License Number StateOH

VIII. Authorized Official

Name: MS. ROBERTA L LADRIE
Title or Position: EXECUTIVE VICE PRESIDENT
Credential: RN BSN EMBA
Phone: 216-931-1320