Provider Demographics
NPI:1205981321
Name:MONTEFIORE HOME
Entity type:Organization
Organization Name:MONTEFIORE HOME
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP, HOSPICE & PALLIATIVE CARE
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:PIKOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-563-6291
Mailing Address - Street 1:ONE DAVID N MYERS PARKWAY
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:216-910-2641
Mailing Address - Fax:216-910-2299
Practice Address - Street 1:ONE DAVID N MYERS PARKWAY
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122
Practice Address - Country:US
Practice Address - Phone:216-910-2641
Practice Address - Fax:216-910-2299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0058HSP251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0915451Medicaid
OH0915451Medicaid