Provider Demographics
NPI:1083950257
Name:DEBTINY RESIDENTIAL HEALTH CARE
Entity Type:Organization
Organization Name:DEBTINY RESIDENTIAL HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR ADMINSITRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:216-394-1905
Mailing Address - Street 1:15318 JUDSON DR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-1959
Mailing Address - Country:US
Mailing Address - Phone:216-990-4261
Mailing Address - Fax:
Practice Address - Street 1:15318 JUDSON DR
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-1959
Practice Address - Country:US
Practice Address - Phone:216-990-4261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health