Provider Demographics
NPI:1477372183
Name:CANTILLON, CHRISTINE ELAINE
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:ELAINE
Last Name:CANTILLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3838 BROOKSIDE BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111
Mailing Address - Country:US
Mailing Address - Phone:216-251-0611
Mailing Address - Fax:
Practice Address - Street 1:3838 BROOKSIDE BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-5105
Practice Address - Country:US
Practice Address - Phone:216-251-0611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty