Provider Demographics
NPI:1235847146
Name:CLEVELANDS HOME CARE SERVICE INC
Entity Type:Organization
Organization Name:CLEVELANDS HOME CARE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ELISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:NNAJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-750-6100
Mailing Address - Street 1:507 WOODSIDE DR
Mailing Address - Street 2:
Mailing Address - City:KINGS MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28086-2451
Mailing Address - Country:US
Mailing Address - Phone:704-750-6100
Mailing Address - Fax:704-750-6103
Practice Address - Street 1:507 WOODSIDE DR
Practice Address - Street 2:
Practice Address - City:KINGSMOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28086-2808
Practice Address - Country:US
Practice Address - Phone:704-750-6100
Practice Address - Fax:704-750-6103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-09
Last Update Date:2023-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care