Provider Demographics
NPI:1073935961
Name:PASSERELL ENTERPRISES, INC
Entity Type:Organization
Organization Name:PASSERELL ENTERPRISES, INC
Other - Org Name:COMFORT KEEPERS 286
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:M
Authorized Official - Last Name:PASSERELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-722-6444
Mailing Address - Street 1:1114 N COURT ST
Mailing Address - Street 2:#230
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-1579
Mailing Address - Country:US
Mailing Address - Phone:330-722-6444
Mailing Address - Fax:330-722-4334
Practice Address - Street 1:3812 PEARL RD.
Practice Address - Street 2:SUITE #17
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256
Practice Address - Country:US
Practice Address - Phone:330-722-6444
Practice Address - Fax:330-722-4334
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PASSERELL ENTERPRISES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-10
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care