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General NPI Number Information
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NPI Number | 1952736662
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Entity Type | Organization
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Legal Business Name | CLEVELAND HOME DIALYSIS, LLC
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Dates
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Enumeration Date | 09/12/2013
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Last Update Date | 09/12/2013
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Provider Practice Location Address
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Address Line | 12000 MCCRACKEN RD 153
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City | CLEVELAND
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State | OH
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Zip | 44125-2964
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Country | US
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Telephone | 216-510-4765
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Fax |
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Provider Business Mailing Address
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Address Line | 12000 MCCRACKEN RD 153
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City | CLEVELAND
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State | OH
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Zip | 44125-2964
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. TANIA ALAMIR
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Credential |
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Telephone | 216-570-0600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State | OH
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