Provider Demographics
NPI:1477140259
Name:KENNEDY, LILIA L
Entity Type:Individual
Prefix:
First Name:LILIA
Middle Name:L
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7103 WESTLAKE AVE
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-2390
Mailing Address - Country:US
Mailing Address - Phone:216-315-1340
Mailing Address - Fax:
Practice Address - Street 1:7103 WESTLAKE AVE
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-2390
Practice Address - Country:US
Practice Address - Phone:216-315-1340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care