Healthcare Provider Details

I. General information

NPI: 1194167148
Provider Name (Legal Business Name): CUPAL HOME HEALTH AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2013
Last Update Date: 07/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 E 45TH ST STE 224
CLEVELAND OH
44127-1089
US

IV. Provider business mailing address

3100 E 45TH ST STE 224
CLEVELAND OH
44127-1089
US

V. Phone/Fax

Practice location:
  • Phone: 216-672-8981
  • Fax: 216-441-0893
Mailing address:
  • Phone: 216-672-8981
  • Fax: 216-441-0893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: PATRICK OGBONNAYA OKOROAFOR
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 216-672-8981