Provider Demographics
NPI:1023796802
Name:DANISA, BIGIRIMANA
Entity type:Individual
Prefix:
First Name:BIGIRIMANA
Middle Name:
Last Name:DANISA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4124 SACKETT AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-1289
Mailing Address - Country:US
Mailing Address - Phone:240-353-6579
Mailing Address - Fax:
Practice Address - Street 1:4124 SACKETT AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-1289
Practice Address - Country:US
Practice Address - Phone:240-353-6579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility