Provider Demographics
NPI:1992182315
Name:SIGNIFICANT RESIDENTIAL CARE SERVICES LLC
Entity Type:Organization
Organization Name:SIGNIFICANT RESIDENTIAL CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TALENNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-776-9219
Mailing Address - Street 1:13211 LARCHMERE BLVD APT D22
Mailing Address - Street 2:
Mailing Address - City:SHAKER HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44120-1383
Mailing Address - Country:US
Mailing Address - Phone:216-776-9219
Mailing Address - Fax:216-563-1048
Practice Address - Street 1:13211 LARCHMERE BLVD APT D22
Practice Address - Street 2:
Practice Address - City:SHAKER HTS
Practice Address - State:OH
Practice Address - Zip Code:44120-1383
Practice Address - Country:US
Practice Address - Phone:216-776-9219
Practice Address - Fax:216-563-1048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-05
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1824860251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health