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General NPI Number Information
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NPI Number | 1699006643
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Entity Type | Organization
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Legal Business Name | IBARIHEALTH
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Dates
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Enumeration Date | 01/14/2010
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Last Update Date | 01/14/2010
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Provider Practice Location Address
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Address Line | 17000 SAINT CLAIR AVE BUILDING 1
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City | CLEVELAND
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State | OH
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Zip | 44110-2535
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Country | US
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Telephone | 773-687-8007
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Fax |
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Provider Business Mailing Address
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Address Line | 17000 SAINT CLAIR AVE BUILDING 1
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City | CLEVELAND
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State | OH
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Zip | 44110-2535
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Country | US
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Telephone | 773-687-8007
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. KEVIN DALE HUFFMAN
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Credential | D.O.
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Telephone | 773-687-8007
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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 |
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License Number State |
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