MEDICARE: MONICA'S CARIBBEAN BAKERY & CAFE

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	332U00000X	Home Delivered Meals	3340	OH

General Provider Information

NPI Number	:	1730386806
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONICA'S CARIBBEAN BAKERY & CAFE

Provider Business Mailing Address
First Line	:	644 E 185TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44119-1767
Country	:	US
Telephone Number	:	216-481-7776
Fax Number	:	216-481-7776

Provider Business Practice Location Address
First Line	:	644 E 185TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44119-1767
Country	:	US
Telephone Number	:	216-481-7776
Fax Number	:	216-481-7776

Authorized Official
Title or Position	:	OWNER-DIRECTOR
Name	:	MS. MONICA JENNIFER LIMERICK
Credential	:	CDM
Telephone Number	:	216-289-8908

Provider Enumeration Date	:	06/30/2007
Last Update Date	:	08/22/2020

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