Provider Demographics
NPI:1346417516
Name:JOSHUAS HOUSE(LANE LEASING INC)
Entity Type:Organization
Organization Name:JOSHUAS HOUSE(LANE LEASING INC)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:P
Authorized Official - Last Name:BRAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-310-0815
Mailing Address - Street 1:29057 CHARDON RD
Mailing Address - Street 2:
Mailing Address - City:WICKLIFFE
Mailing Address - State:OH
Mailing Address - Zip Code:44092-1402
Mailing Address - Country:US
Mailing Address - Phone:216-310-0815
Mailing Address - Fax:
Practice Address - Street 1:29057 CHARDON RD
Practice Address - Street 2:
Practice Address - City:WICKLIFFE
Practice Address - State:OH
Practice Address - Zip Code:44092-1402
Practice Address - Country:US
Practice Address - Phone:216-310-0815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1477923385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care