Provider Demographics
NPI:1780022962
Name:UNITY AGENCY FOR DEVELOPMENTAL DISABILILE
Entity Type:Organization
Organization Name:UNITY AGENCY FOR DEVELOPMENTAL DISABILILE
Other - Org Name:UNITY GROUP HOMES & INDEPENDENT LIVING LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO LPN
Authorized Official - Prefix:
Authorized Official - First Name:VANASHIA
Authorized Official - Middle Name:LASHAY
Authorized Official - Last Name:CONNER
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:614-715-1764
Mailing Address - Street 1:3593 E 59TH ST
Mailing Address - Street 2:DOWN
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-1249
Mailing Address - Country:US
Mailing Address - Phone:614-715-1764
Mailing Address - Fax:
Practice Address - Street 1:3593 E 59TH ST
Practice Address - Street 2:DOWN
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-1249
Practice Address - Country:US
Practice Address - Phone:614-715-1764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health