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General NPI Number Information
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NPI Number | 1265255061
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Entity Type | Organization
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Legal Business Name | BLUSTONE MANAGEMENT LLC
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Dates
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Enumeration Date | 11/01/2024
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 13446 CEDAR RD
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City | CLEVELAND HEIGHTS
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State | OH
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Zip | 44118-2921
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Country | US
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Telephone | 216-203-3848
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Fax |
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Provider Business Mailing Address
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Address Line | 420 E 270TH ST
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City | EUCLID
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State | OH
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Zip | 44132-1708
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Country | US
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Telephone | 216-203-3848
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Fax |
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Authorized Official
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Title or Position | PRESIDENT 1
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Name | MISS CIARRA TANAY BRADLEY
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Credential |
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Telephone | 216-203-3848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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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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Taxonomy #5
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Taxonomy Code | 261QR0800X
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Taxonomy Name | Recovery Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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