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General NPI Number Information
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NPI Number | 1639223795
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Entity Type | Organization
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Legal Business Name | ELDERHOOD COMMUNITY SERVICES
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 01/30/2009
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Provider Practice Location Address
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Address Line | 3085 CLAGUE RD
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City | NORTH OLMSTED
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State | OH
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Zip | 44070-1179
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Country | US
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Telephone | 440-871-0090
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Fax | 440-617-9148
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Provider Business Mailing Address
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Address Line | 3085 CLAGUE RD
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City | NORTH OLMSTED
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State | OH
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Zip | 44070-1179
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Country | US
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Telephone | 440-871-0090
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Fax | 440-617-9148
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. LISA M SALMONS
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Credential |
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Telephone | 440-871-0090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 0000000000
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License Number State | OH
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