Provider Demographics
NPI:1457628083
Name:WESTERN RESERVE AREA AGENCY ON AGING
Entity Type:Organization
Organization Name:WESTERN RESERVE AREA AGENCY ON AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:T
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:216-621-0303
Mailing Address - Street 1:1700 E 13TH ST STE 114
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44114-3285
Mailing Address - Country:US
Mailing Address - Phone:216-621-0303
Mailing Address - Fax:216-621-7171
Practice Address - Street 1:1700 E 13TH ST STE 114
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-3285
Practice Address - Country:US
Practice Address - Phone:216-621-0303
Practice Address - Fax:216-621-7171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty