MEDICARE: PAIGE FITCH

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	320700000X	Physical Disabilities Residential Treatment Facility	PN126022-M-IV	OH

General Provider Information

NPI Number	:	1356775159
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAIGE FITCH

Provider Business Mailing Address
First Line	:	2627 COLCHESTER RD
Second Line	:	3RD FLOOR
City	:	CLEVELAND HTS
State	:	OH
Zip	:	44106-3664
Country	:	US
Telephone Number	:	216-812-5256
Fax Number	:

Provider Business Practice Location Address
First Line	:	2627 COLCHESTER RD
Second Line	:	3RD FLOOR
City	:	CLEVELAND HTS
State	:	OH
Zip	:	44106-3664
Country	:	US
Telephone Number	:	216-812-5256
Fax Number	:

Authorized Official
Title or Position	:	LPN
Name	:	PAIGE T FITCH
Credential	:	LPN
Telephone Number	:	216-812-5256

Provider Enumeration Date	:	08/28/2013
Last Update Date	:	08/28/2013

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Directions to “PAIGE FITCH ” Practice Location

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