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NPI Code Detail

MEDICARE: MADISON GROUP HOME

MEDICARE: MADISON GROUP 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
1311ZA0620XAdult Care Home Facility

General Provider Information

NPI Number : 1619811890
Entity Type Code : Organization
Provider Name (Legal Business Name) : MADISON GROUP HOME
Provider Business Mailing Address
First Line : 11510 MADISON AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44102-2326
Country : US
Telephone Number : 216-851-1853
Fax Number :
Provider Business Practice Location Address
First Line : 11510 MADISON AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44102-2326
Country : US
Telephone Number : 216-851-1853
Fax Number :
Authorized Official
Title or Position : OWNER
Name : SHIMON RUBIN
Credential :
Telephone Number : 330-429-5335
Provider Enumeration Date : 04/16/2026
Last Update Date : 04/16/2026

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Directions to “MADISON GROUP HOME ” Practice Location

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