Healthcare Provider Details

I. General information

NPI: 1487323655
Provider Name (Legal Business Name): YOUR PLACE & MINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2021
Last Update Date: 11/01/2022
Certification Date: 11/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5353 DOLLOFF RD
CLEVELAND OH
44127-1620
US

IV. Provider business mailing address

PO BOX 91913
CLEVELAND OH
44101-3913
US

V. Phone/Fax

Practice location:
  • Phone: 216-532-5512
  • Fax:
Mailing address:
  • Phone: 216-532-5512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: RENEE HILL
Title or Position: CEO
Credential:
Phone: 216-236-8336