Provider Demographics
NPI:1558791699
Name:LESLIE ANN DIXON
Entity Type:Organization
Organization Name:LESLIE ANN DIXON
Other - Org Name:LESLIE ANN DIXON
Other - Org Type:Other Name
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:MS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:216-849-3184
Mailing Address - Street 1:3614 WARREN RD
Mailing Address - Street 2:3614 WARREN ROAD DOWN
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-3040
Mailing Address - Country:US
Mailing Address - Phone:216-849-3184
Mailing Address - Fax:
Practice Address - Street 1:3614 WARREN RD
Practice Address - Street 2:3614 WARREN ROAD DOWN
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-3040
Practice Address - Country:US
Practice Address - Phone:216-849-3184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-26
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.151788-M-IV251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health