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General NPI Number Information
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NPI Number | 1790555365
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Entity Type | Organization
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Legal Business Name | KEKEE'S HOUSE OF LOVE
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Dates
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Enumeration Date | 01/04/2024
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Last Update Date | 01/04/2024
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Provider Practice Location Address
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Address Line | 8613 DENISON AVE UNIT 3
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City | CLEVELAND
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State | OH
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Zip | 44102-4923
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Country | US
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Telephone | 216-250-6202
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Fax |
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Provider Business Mailing Address
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Address Line | 8613 DENISON AVE UNIT 3
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City | CLEVELAND
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State | OH
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Zip | 44102-4923
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Country | US
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Telephone | 216-250-6202
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LAKIAH R SAMPSON
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Credential |
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Telephone | 216-302-4722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 385HR2065X
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Taxonomy Name | Child Physical Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #6
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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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