MEDICARE: ANGELA JONES

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
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1205420015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA JONES

Provider Business Mailing Address
First Line	:	3100 E 45TH ST STE 116
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44127-1094
Country	:	US
Telephone Number	:	216-232-5455
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 E 45TH ST STE 116
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44127-1094
Country	:	US
Telephone Number	:	216-232-5455
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2021
Last Update Date	:	10/06/2021

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Directions to “ ANGELA JONES ” Practice Location

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