Healthcare Provider Details

I. General information

NPI: 1740404888
Provider Name (Legal Business Name): NEW AVENUES TO INDEPENDENCE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2441 EDGERTON RD
UNIVERSITY HEIGHTS OH
44118-4410
US

IV. Provider business mailing address

17608 EUCLID AVE
CLEVELAND OH
44112-1216
US

V. Phone/Fax

Practice location:
  • Phone: 216-481-1909
  • Fax: 216-481-2050
Mailing address:
  • Phone: 216-481-1909
  • Fax: 216-481-2050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number9370
License Number StateOH

VIII. Authorized Official

Name: THOMAS M LEWINS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 216-481-1909