MEDICARE: LONDON PREMIER CARE RESIDENCES LLC

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	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility

General Provider Information

NPI Number	:	1952279135
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LONDON PREMIER CARE RESIDENCES LLC

Provider Business Mailing Address
First Line	:	844 LONDON RD STE 101
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44110-3374
Country	:	US
Telephone Number	:	216-906-1792
Fax Number	:

Provider Business Practice Location Address
First Line	:	844 LONDON RD STE 101
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44110-3374
Country	:	US
Telephone Number	:	216-906-1792
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TERREIA S WHITSETT
Credential	:
Telephone Number	:	216-906-1792

Provider Enumeration Date	:	10/28/2025
Last Update Date	:	10/28/2025

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