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General NPI Number Information
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NPI Number | 1699483966
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Entity Type | Organization
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Legal Business Name | STRONG TOWER LIVING AT HOME LLC
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Dates
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Enumeration Date | 11/07/2022
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Last Update Date | 11/07/2022
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Provider Practice Location Address
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Address Line | 3676 E 118TH ST
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City | CLEVELAND
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State | OH
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Zip | 44105-2558
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Country | US
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Telephone | 216-855-7692
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Fax |
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Provider Business Mailing Address
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Address Line | 4977 PENNY LN
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City | NORTH OLMSTED
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State | OH
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Zip | 44070-5417
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Country | US
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Telephone | 216-855-7692
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. JEROME CASTLEBERRY SR.
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Credential |
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Telephone | 216-855-7692
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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