Healthcare Provider Details

I. General information

NPI: 1962088294
Provider Name (Legal Business Name): COMMUNITY BOUND AGENCY NEW DAY LEADERS LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2021
Last Update Date: 03/18/2021
Certification Date: 03/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33140 AURORA RD STE 10
SOLON OH
44139-3650
US

IV. Provider business mailing address

33140 AURORA RD STE 10
SOLON OH
44139-3650
US

V. Phone/Fax

Practice location:
  • Phone: 440-600-2636
  • Fax:
Mailing address:
  • Phone: 440-600-2636
  • Fax:

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 Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: MARCELLA J SINGLETON
Title or Position: SUPERVISOR/PROPRIETOR
Credential:
Phone: 216-288-5572