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General NPI Number Information
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NPI Number | 1164925566
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Entity Type | Organization
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Legal Business Name | WESTCHESTER HOUSE ADULT FAMILY HOME LLC
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Dates
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Enumeration Date | 03/12/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 10305 WESTCHESTER AVE
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City | CLEVELAND
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State | OH
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Zip | 44108-3461
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Country | US
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Telephone | 216-772-5450
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Fax | 216-649-0665
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Provider Business Mailing Address
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Address Line | 10305 WESTCHESTER AVE
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City | CLEVELAND
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State | OH
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Zip | 44108-3461
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Country | US
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Telephone | 216-772-5450
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Fax | 216-649-0665
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Authorized Official
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Title or Position | OWNER
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Name | MS. TERESA LAFAYE WAKEFIELD
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Credential |
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Telephone | 216-772-5450
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 180795
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License Number State | OH
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