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General NPI Number Information
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NPI Number | 1558791699
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Entity Type | Organization
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Legal Business Name | LESLIE ANN DIXON
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Dates
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Enumeration Date | 11/26/2013
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Last Update Date | 11/26/2013
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Provider Practice Location Address
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Address Line | 3614 WARREN RD 3614 WARREN ROAD DOWN
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City | CLEVELAND
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State | OH
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Zip | 44111-3040
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Country | US
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Telephone | 216-849-3184
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Fax |
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Provider Business Mailing Address
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Address Line | 3614 WARREN RD 3614 WARREN ROAD DOWN
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City | CLEVELAND
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State | OH
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Zip | 44111-3040
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Country | US
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Telephone | 216-849-3184
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Fax |
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Authorized Official
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Title or Position | LPN
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Name | MS. LESLIE ANN DIXON
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Credential | LPN
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Telephone | 216-849-3184
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | PN.151788-M-IV
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License Number State | OH
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