Healthcare Provider Details

I. General information

NPI: 1932849767
Provider Name (Legal Business Name): AFRICAHOUSE INTERNATIONAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 03/31/2022
Certification Date: 03/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1695 EAST 81ST STREET #1
CLEVELAND OH
44103
US

IV. Provider business mailing address

1695 EAST 81ST STREET SUITE 1
CLEVELAND OH
44103
US

V. Phone/Fax

Practice location:
  • Phone: 216-376-7206
  • Fax: 216-421-0298
Mailing address:
  • Phone: 216-376-7206
  • Fax: 216-421-0298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: AKUSIKA NKOMOMACKEY
Title or Position: FOUNDER & CEO
Credential:
Phone: 216-421-0298