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General NPI Number Information
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NPI Number | 1770232399
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Entity Type | Individual
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Provider Name | SAMANTHA RUTH HAMBLEN
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Gender | Female
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Dates
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Enumeration Date | 03/21/2022
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Last Update Date | 03/21/2022
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Provider Practice Location Address
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Address Line | 3726 W 42ND ST
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City | CLEVELAND
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State | OH
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Zip | 44109-2472
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Country | US
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Telephone | 216-310-8142
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Fax |
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Provider Business Mailing Address
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Address Line | 8517 VINEYARD AVE
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City | CLEVELAND
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State | OH
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Zip | 44105-6620
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Country | US
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Telephone | 216-450-8985
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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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