Provider Demographics
NPI:1114133857
Name:VAN AKEN HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:VAN AKEN HEALTH CENTER, INC.
Other - Org Name:VAN AKEN THERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BROCCOLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:216-561-1994
Mailing Address - Street 1:20119 VAN AKEN BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-3636
Mailing Address - Country:US
Mailing Address - Phone:216-561-1994
Mailing Address - Fax:216-561-0553
Practice Address - Street 1:20119 VAN AKEN BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122-3636
Practice Address - Country:US
Practice Address - Phone:216-561-1994
Practice Address - Fax:216-561-0553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2432111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty