Provider Demographics
NPI:1649054016
Name:LIGON, ANTOINETTE
Entity type:Individual
Prefix:MS
First Name:ANTOINETTE
Middle Name:
Last Name:LIGON
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 1:111 E 233RD ST APT 128
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44123-1182
Mailing Address - Country:US
Mailing Address - Phone:216-551-2637
Mailing Address - Fax:
Practice Address - Street 1:111 E 233RD ST APT 128
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44123-1182
Practice Address - Country:US
Practice Address - Phone:216-551-2637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities