Healthcare Provider Details

I. General information

NPI: 1891824769
Provider Name (Legal Business Name): DOBB INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 04/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 EAST 62ND STREET
CLEVELAND OH
44103-1093
US

IV. Provider business mailing address

1030 EAST 62ND STREET
CLEVELAND OH
44103-1093
US

V. Phone/Fax

Practice location:
  • Phone: 216-361-1152
  • Fax: 216-361-1154
Mailing address:
  • Phone: 216-361-1152
  • Fax: 216-361-1154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number185095
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number1815414
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number1815414
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1815414
License Number StateOH

VIII. Authorized Official

Name: MR. SOLOMON A DOIBO
Title or Position: C.E.O
Credential:
Phone: 216-361-1152