Provider Demographics
NPI:1619352200
Name:VALENCIA WALTON
Entity Type:Organization
Organization Name:VALENCIA WALTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:
Authorized Official - First Name:VALENCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-302-5173
Mailing Address - Street 1:26151 LAKE SHORE BLVD
Mailing Address - Street 2:1915
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-1176
Mailing Address - Country:US
Mailing Address - Phone:216-302-5173
Mailing Address - Fax:
Practice Address - Street 1:26151 LAKE SHORE BLVD
Practice Address - Street 2:1915
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-1176
Practice Address - Country:US
Practice Address - Phone:216-302-5173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-23
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH156223251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care