Provider Demographics
NPI:1598198731
Name:AQUILLA CARE
Entity Type:Organization
Organization Name:AQUILLA CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:AQUILLA
Authorized Official - Last Name:WHEADON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-249-5655
Mailing Address - Street 1:540 E 105TH ST
Mailing Address - Street 2:SUITE 202D
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44108-4301
Mailing Address - Country:US
Mailing Address - Phone:216-235-0639
Mailing Address - Fax:216-249-5655
Practice Address - Street 1:540 E 105TH ST
Practice Address - Street 2:SUITE 202D
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44108-4301
Practice Address - Country:US
Practice Address - Phone:216-235-0639
Practice Address - Fax:216-249-5655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health