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General NPI Number Information
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NPI Number | 1184281404
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Entity Type | Organization
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Legal Business Name | SENIOR LOVING CARE, LLC
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Dates
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Enumeration Date | 05/22/2019
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Last Update Date | 05/22/2019
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Provider Practice Location Address
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Address Line | 17325 EUCLID AVE STE 2049A
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City | CLEVELAND
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State | OH
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Zip | 44112-1247
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Country | US
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Telephone | 216-332-7727
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 21087
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City | SOUTH EUCLID
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State | OH
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Zip | 44121-0087
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Country | US
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Telephone | 216-233-7727
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHIRLEY J SISTRUNK
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Credential |
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Telephone | 216-233-7727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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