Healthcare Provider Details

I. General information

NPI: 1336480672
Provider Name (Legal Business Name): LAKE COUNTY AROUND THE CLOCK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2013
Last Update Date: 03/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 E MAIN ST SUITE 200
PAINESVILLE OH
44077-3856
US

IV. Provider business mailing address

270 E MAIN ST SUITE 200
PAINESVILLE OH
44077-3856
US

V. Phone/Fax

Practice location:
  • Phone: 440-350-2547
  • Fax: 440-350-1997
Mailing address:
  • Phone: 440-350-2547
  • Fax: 440-350-1997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. CARMEN LYNN ETTINGER
Title or Position: EXECUTIVE DIRECTOR
Credential: MHA
Phone: 440-350-2547