Provider Demographics
NPI:1669140596
Name:KINDRED SPIRITS ADULT DAY HAB CENTER LLC
Entity type:Organization
Organization Name:KINDRED SPIRITS ADULT DAY HAB CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-894-8967
Mailing Address - Street 1:11812 BUCKINGHAM AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-1948
Mailing Address - Country:US
Mailing Address - Phone:216-894-8967
Mailing Address - Fax:216-373-6565
Practice Address - Street 1:11812 BUCKINGHAM AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-1948
Practice Address - Country:US
Practice Address - Phone:216-894-8967
Practice Address - Fax:216-373-6565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-03
Last Update Date:2025-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No332U00000XSuppliersHome Delivered MealsGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health Aide
No385H00000XRespite Care FacilityRespite Care
No251E00000XAgenciesHome Health