Healthcare Provider Details

I. General information

NPI: 1730386806
Provider Name (Legal Business Name): MONICA'S CARIBBEAN BAKERY & CAFE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

644 E 185TH ST
CLEVELAND OH
44119-1767
US

IV. Provider business mailing address

644 E 185TH ST
CLEVELAND OH
44119-1767
US

V. Phone/Fax

Practice location:
  • Phone: 216-481-7776
  • Fax: 216-481-7776
Mailing address:
  • Phone: 216-481-7776
  • Fax: 216-481-7776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number3340
License Number StateOH

VIII. Authorized Official

Name: MS. MONICA JENNIFER LIMERICK
Title or Position: OWNER-DIRECTOR
Credential: CDM
Phone: 216-289-8908