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General NPI Number Information
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NPI Number | 1659676880
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Entity Type | Organization
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Legal Business Name | OSTELLAFRAN ADULT DAY SERVICES, LLC
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Dates
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Enumeration Date | 01/19/2011
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Last Update Date | 01/19/2011
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Provider Practice Location Address
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Address Line | 291 E 222ND ST STE 157
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City | EUCLID
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State | OH
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Zip | 44123-1718
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Country | US
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Telephone | 216-797-9920
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Fax | 216-797-9921
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Provider Business Mailing Address
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Address Line | 291 E 222ND ST STE 157
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City | EUCLID
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State | OH
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Zip | 44123-1718
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Country | US
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Telephone | 216-797-9920
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Fax | 216-797-9921
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | MRS. LAVONA MARIE LEWIS
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Credential | OTR/L
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Telephone | 216-797-9920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | OT4283
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License Number State | OH
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