MEDICARE: VIRTUALSCHOOLHOUSE

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	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1881891687
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIRTUALSCHOOLHOUSE

Provider Business Mailing Address
First Line	:	736 LAKEVIEW RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44108-2608
Country	:	US
Telephone Number	:	216-541-2048
Fax Number	:	216-541-2018

Provider Business Practice Location Address
First Line	:	736 LAKEVIEW RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44108-2608
Country	:	US
Telephone Number	:	216-541-2048
Fax Number	:	216-541-2018

Authorized Official
Title or Position	:	CEO
Name	:	MRS. NICKI SALFER
Credential	:	MA, MS
Telephone Number	:	216-541-2048

Provider Enumeration Date	:	06/27/2007
Last Update Date	:	02/19/2009

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Directions to “VIRTUALSCHOOLHOUSE ” Practice Location

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