=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689262982
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | A BETTER COMMUNITY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/04/2021
-----------------------------------------------------
Last Update Date | 01/04/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7611 MARBLE DOWN
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44105-4410
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-451-4774
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15539 SARANAC RD
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44110-2458
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-931-6578
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/CEO
-----------------------------------------------------
Name | MR. BRIAN MONROE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 216-451-4774
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 376J00000X
-----------------------------------------------------
Taxonomy Name | Homemaker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------