Provider Demographics
NPI:1598738718
Name:CLEVELAND CLINIC HOME CARE SERVICES
Entity Type:Organization
Organization Name:CLEVELAND CLINIC HOME CARE SERVICES
Other - Org Name:HOSPICE OF THE CLEVELAND CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER, REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:P
Authorized Official - Last Name:ONLAYAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-636-8812
Mailing Address - Street 1:PO BOX 931664
Mailing Address - Street 2:HOSPICE OF CLEVELAND CLINIC
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-1777
Mailing Address - Country:US
Mailing Address - Phone:216-444-9819
Mailing Address - Fax:216-520-1973
Practice Address - Street 1:6801 BRECKSVILLE RD
Practice Address - Street 2:SUITE # 10 ATTN: ADMINISTRATOR/DIRECTOR
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-5032
Practice Address - Country:US
Practice Address - Phone:216-444-9819
Practice Address - Fax:216-520-1973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-08
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0850575Medicaid
OH361554Medicare Oscar/Certification
OH0850575Medicaid