MEDICARE: LASHAE ALEXANDRIA KING

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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1477217974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LASHAE ALEXANDRIA KING

Provider Business Mailing Address
First Line	:	4415 EUCLID AVE STE 335
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44103-3758
Country	:	US
Telephone Number	:	440-616-6660
Fax Number	:

Provider Business Practice Location Address
First Line	:	4415 EUCLID AVE STE 335
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44103-3758
Country	:	US
Telephone Number	:	440-616-6660
Fax Number	:

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

Provider Enumeration Date	:	10/30/2021
Last Update Date	:	10/30/2021

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Directions to “ LASHAE ALEXANDRIA KING ” Practice Location

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