=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134938558
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NEW AVENUES TO INDEPENDENCE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/31/2024
-----------------------------------------------------
Last Update Date | 05/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3615 SUPERIOR AVE E STE 4404
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44114-4138
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-339-6008
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3615 SUPERIOR AVE E
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44114-4138
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-339-6008
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF QUALITY & COMPLIANCE
-----------------------------------------------------
Name | RICRISHA WALKER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 216-870-5214
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 315P00000X
-----------------------------------------------------
Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------