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NPI Code Detail

MEDICARE: KEMPER HOUSE HIGHLAND HEIGHTS OPERATING COMPANY LLC

MEDICARE: KEMPER HOUSE HIGHLAND HEIGHTS OPERATING COMPANY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1311500000XAlzheimer Center (Dementia Center)

General Provider Information

NPI Number : 1114324217
Entity Type Code : Organization
Provider Name (Legal Business Name) : KEMPER HOUSE HIGHLAND HEIGHTS OPERATING COMPANY LLC
Provider Business Mailing Address
First Line : 10307 DETROIT AVE
Second Line : SUITE 101
City : CLEVELAND
State : OH
Zip : 44102-1604
Country : US
Telephone Number : 216-472-4200
Fax Number : 216-472-4220
Provider Business Practice Location Address
First Line : 407 GOLFVIEW LN
Second Line :
City : HIGHLAND HEIGHTS
State : OH
Zip : 44143-4414
Country : US
Telephone Number : 440-461-0600
Fax Number :
Authorized Official
Title or Position : AUTHORIZED REPRESENTITIVE
Name : BETTY KEMPER
Credential :
Telephone Number : 216-472-4200
Provider Enumeration Date : 12/04/2014
Last Update Date : 12/04/2014

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