Provider Demographics
NPI:1871264978
Name:ECHO HOSPICE OF CLEVELAND, LLC
Entity Type:Organization
Organization Name:ECHO HOSPICE OF CLEVELAND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LACKNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-412-4909
Mailing Address - Street 1:12680 HIGH BLUFF DR STE 150
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2232
Mailing Address - Country:US
Mailing Address - Phone:918-576-3070
Mailing Address - Fax:
Practice Address - Street 1:7770 BRECKSVILLE RD STE 4
Practice Address - Street 2:
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141-1074
Practice Address - Country:US
Practice Address - Phone:216-400-9055
Practice Address - Fax:216-400-9115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based