=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245606995
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORWILL HEALTHCARE SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/18/2015
-----------------------------------------------------
Last Update Date | 09/09/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3100 E 45TH ST SUITE 224
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44127-1088
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-324-1338
-----------------------------------------------------
Fax | 216-373-4969
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3100 E 45TH ST STE 102
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44127-1094
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-441-9669
-----------------------------------------------------
Fax | 216-373-4969
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. OLIETUNJA D MANN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 216-441-9669
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 385H00000X
-----------------------------------------------------
Taxonomy Name | Respite Care
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------