Provider Demographics
NPI:1265022545
Name:CITY OF REFUGE HOMES, LLC
Entity Type:Organization
Organization Name:CITY OF REFUGE HOMES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:NONE
Authorized Official - Phone:216-990-1109
Mailing Address - Street 1:840 ARCHER RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44146-2978
Mailing Address - Country:US
Mailing Address - Phone:216-990-1109
Mailing Address - Fax:
Practice Address - Street 1:840 ARCHER RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146-2978
Practice Address - Country:US
Practice Address - Phone:216-990-1109
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home