Provider Demographics
NPI:1043564768
Name:EQUAL OPPORTUNITY HOUSING, LLC
Entity Type:Organization
Organization Name:EQUAL OPPORTUNITY HOUSING, LLC
Other - Org Name:CELEBRATION HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:440-466-5004
Mailing Address - Street 1:106 ELM ST
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:OH
Mailing Address - Zip Code:44041-1004
Mailing Address - Country:US
Mailing Address - Phone:440-466-5004
Mailing Address - Fax:
Practice Address - Street 1:106 ELM ST
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:OH
Practice Address - Zip Code:44041-1004
Practice Address - Country:US
Practice Address - Phone:440-466-5004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-02
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities