Provider Demographics
NPI:1962453563
Name:JUST LIKE FAMILEE III, INC
Entity Type:Organization
Organization Name:JUST LIKE FAMILEE III, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DELORES
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:330-425-0220
Mailing Address - Street 1:2234 E ENTERPRISE PKWY
Mailing Address - Street 2:
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-2393
Mailing Address - Country:US
Mailing Address - Phone:330-425-0220
Mailing Address - Fax:330-425-0231
Practice Address - Street 1:2000 LEE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-2572
Practice Address - Country:US
Practice Address - Phone:330-425-0220
Practice Address - Fax:330-425-0231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1618913251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH368204Medicare Oscar/Certification