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General NPI Number Information
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NPI Number | 1396574075
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Entity Type | Organization
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Legal Business Name | SKYHAWK HEALTHCARE & RESIDENCE LLC
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Dates
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Enumeration Date | 07/30/2024
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Last Update Date | 07/30/2024
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Provider Practice Location Address
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Address Line | 5815 LANDERBROOK DR
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City | CLEVELAND
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State | OH
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Zip | 44124-7900
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Country | US
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Telephone | 786-372-1223
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Fax |
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Provider Business Mailing Address
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Address Line | 5815 LANDERBROOK DR
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City | CLEVELAND
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State | OH
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Zip | 44124-7900
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AKEEM WILSON
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Credential |
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Telephone | 786-372-1223
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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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