MEDICARE: ADORA HEALTHCARE SERVICES

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	163W00000X	Registered Nurse	RN 317817	OH

General Provider Information

NPI Number	:	1548254592
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADORA HEALTHCARE SERVICES

Provider Business Mailing Address
First Line	:	3327 MARMORE AVE
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44134-1209
Country	:	US
Telephone Number	:	216-544-5418
Fax Number	:	216-741-1419

Provider Business Practice Location Address
First Line	:	3327 MARMORE AVE
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44134-1209
Country	:	US
Telephone Number	:	216-544-5418
Fax Number	:	216-741-1419

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	PETER TAMUNOH TEBOH
Credential	:	RN, MBA, MPH
Telephone Number	:	216-544-5418

Provider Enumeration Date	:	09/06/2005
Last Update Date	:	08/22/2020

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