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NPI Code Detail

MEDICARE: MRS. CHRISTINE ELAINE CANTILLON

MEDICARE:  MRS. CHRISTINE ELAINE CANTILLON
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
1374U00000XHome Health Aide
2385HR2060XChild Intellectual and/or Developmental Disabilities Respite Care

General Provider Information

NPI Number : 1477372183
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHRISTINE ELAINE CANTILLON
Provider Business Mailing Address
First Line : 3838 BROOKSIDE BLVD
Second Line :
City : CLEVELAND
State : OH
Zip : 44111
Country : US
Telephone Number : 216-251-0611
Fax Number :
Provider Business Practice Location Address
First Line : 3838 BROOKSIDE BLVD
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-5105
Country : US
Telephone Number : 216-251-0611
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2024
Last Update Date : 10/09/2024

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Directions to “ MRS. CHRISTINE ELAINE CANTILLON ” Practice Location

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