=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740549294
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | A BETTER WAY OF OHIO LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/03/2012
-----------------------------------------------------
Last Update Date | 05/03/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 291 E 222ND ST SUITE 145
-----------------------------------------------------
City | EUCLID
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44123-1718
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-246-3394
-----------------------------------------------------
Fax | 216-731-7271
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 291 E 222ND ST SUITE 145
-----------------------------------------------------
City | EUCLID
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44123-1718
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-246-3394
-----------------------------------------------------
Fax | 216-731-7271
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MR. CLARENCE LLOYD KIRKPATRICK
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 216-246-3394
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number | 1812775
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------