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General NPI Number Information
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NPI Number | 1164237053
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Entity Type | Organization
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Legal Business Name | OUR COMMUNITY CAREGIVERS LLC
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 511 E 140TH ST
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City | CLEVELAND
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State | OH
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Zip | 44110
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Country | US
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Telephone | 216-209-0583
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Fax |
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Provider Business Mailing Address
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Address Line | 497 TREBISKY RD
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City | RICHMOND HEIGHTS
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State | OH
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Zip | 44143-2821
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Country | US
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Telephone | 216-209-0583
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | CLEMENT LETANG
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Credential |
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Telephone | 216-209-0583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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