Provider Demographics
NPI:1225328479
Name:MEADOWS, RALPH KENNETH
Entity Type:Individual
Prefix:MR
First Name:RALPH
Middle Name:KENNETH
Last Name:MEADOWS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1358 W 61ST ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-2104
Mailing Address - Country:US
Mailing Address - Phone:216-521-6511
Mailing Address - Fax:216-521-6511
Practice Address - Street 1:1358 W 61ST ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-2104
Practice Address - Country:US
Practice Address - Phone:216-521-6511
Practice Address - Fax:216-521-6511
Is Sole Proprietor?:No
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator