Provider Demographics
NPI:1215031380
Name:COUNTY OF CUYAHOGA
Entity Type:Organization
Organization Name:COUNTY OF CUYAHOGA
Other - Org Name:HOME CARE SKILLED SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-420-6756
Mailing Address - Street 1:13815 KINSMAN RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-4417
Mailing Address - Country:US
Mailing Address - Phone:216-420-6789
Mailing Address - Fax:216-420-6735
Practice Address - Street 1:13815 KINSMAN RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-4417
Practice Address - Country:US
Practice Address - Phone:216-420-6789
Practice Address - Fax:216-420-6735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0212264Medicaid
367662Medicare ID - Type Unspecified