Healthcare Provider Details

I. General information

NPI: 1598036113
Provider Name (Legal Business Name): BEREA CHILDRENS HOME AND FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2012
Last Update Date: 01/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 CARNEGIE AVE
CLEVELAND OH
44115-2641
US

IV. Provider business mailing address

3500 CARNEGIE AVE
CLEVELAND OH
44115-2641
US

V. Phone/Fax

Practice location:
  • Phone: 216-406-4253
  • Fax: 440-260-8576
Mailing address:
  • Phone: 216-406-4253
  • Fax: 440-260-8576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberSW68745
License Number StateOH

VIII. Authorized Official

Name: RICHARD FRANK
Title or Position: DIRECTOR
Credential:
Phone: 440-234-2006