Healthcare Provider Details

I. General information

NPI: 1912371774
Provider Name (Legal Business Name): SERVICES FOR INDPENDENT LIVING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2015
Last Update Date: 11/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26250 EUCLID AVE STE 801
EUCLID OH
44132-3718
US

IV. Provider business mailing address

26250 EUCLID AVE STE 801
EUCLID OH
44132-3718
US

V. Phone/Fax

Practice location:
  • Phone: 216-731-1529
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MS. KELLY MCDONALD
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 216-731-1529