Provider Demographics
NPI:1336921535
Name:TAILORED-MADE HEALTHCARE
Entity Type:Organization
Organization Name:TAILORED-MADE HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR (OWNER)
Authorized Official - Prefix:
Authorized Official - First Name:TAILOR
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-647-1503
Mailing Address - Street 1:7315 FREE AVE
Mailing Address - Street 2:
Mailing Address - City:OAKWOOD VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44146-5429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7315 FREE AVE
Practice Address - Street 2:
Practice Address - City:OAKWOOD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44146-5429
Practice Address - Country:US
Practice Address - Phone:216-647-1503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TAILORED-MADE HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No251S00000XAgenciesCommunity/Behavioral Health