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NPI Code Detail

MEDICARE: ELIZA JENNINGS HOME

MEDICARE: ELIZA JENNINGS HOME
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
1314000000XSkilled Nursing Facility4162OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609870138
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELIZA JENNINGS HOME
Provider Business Mailing Address
First Line : 10603 DETROIT AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44102-1647
Country : US
Telephone Number : 216-226-0282
Fax Number : 216-226-8905
Provider Business Practice Location Address
First Line : 10603 DETROIT AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44102-1647
Country : US
Telephone Number : 216-226-0282
Fax Number : 216-226-8905
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MS. BASABI RATNAPARKHI
Credential : LNHA
Telephone Number : 216-226-0282
Provider Enumeration Date : 06/13/2005
Last Update Date : 10/21/2013

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Directions to “ELIZA JENNINGS HOME ” Practice Location

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