Provider Demographics
NPI:1659676880
Name:OSTELLAFRAN ADULT DAY SERVICES, LLC
Entity Type:Organization
Organization Name:OSTELLAFRAN ADULT DAY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAVONA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:216-797-9920
Mailing Address - Street 1:291 E 222ND ST STE 157
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44123-1718
Mailing Address - Country:US
Mailing Address - Phone:216-797-9920
Mailing Address - Fax:216-797-9921
Practice Address - Street 1:291 E 222ND ST STE 157
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44123-1718
Practice Address - Country:US
Practice Address - Phone:216-797-9920
Practice Address - Fax:216-797-9921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-19
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT4283261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care