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General NPI Number Information
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NPI Number | 1417693300
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Entity Type | Individual
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Provider Name | ANTONIO SCOTT
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Gender | Male
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Dates
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Enumeration Date | 05/12/2022
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 13201 GRANGER RD STE 8
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City | CLEVELAND
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State | OH
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Zip | 44125-1979
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Country | US
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Telephone | 216-378-3906
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Fax |
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Provider Business Mailing Address
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Address Line | 1801 WATERMARK DR
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City | COLUMBUS
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State | OH
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Zip | 43215-7088
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Country | US
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Telephone | 614-438-3400
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | RS892339
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License Number State | OH
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