Provider Demographics
NPI:1437552262
Name:ANITA DOOMS
Entity Type:Organization
Organization Name:ANITA DOOMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOOMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-776-8349
Mailing Address - Street 1:4735 WALFORD RD # 16
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-5125
Mailing Address - Country:US
Mailing Address - Phone:216-776-8349
Mailing Address - Fax:
Practice Address - Street 1:4735 WALFORD RD # 16
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-5125
Practice Address - Country:US
Practice Address - Phone:216-776-8349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH150288251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care