Healthcare Provider Details

I. General information

NPI: 1558183079
Provider Name (Legal Business Name): KCE HOMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3392 MILVERTON RD
SHAKER HEIGHTS OH
44120-4248
US

IV. Provider business mailing address

4436 E 156TH ST
CLEVELAND OH
44128-2913
US

V. Phone/Fax

Practice location:
  • Phone: 216-816-8213
  • Fax:
Mailing address:
  • Phone: 216-816-8213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: BELINDA M SMITH
Title or Position: CEO
Credential:
Phone: 216-816-8213