Provider Demographics
NPI:1689477762
Name:NORTH COAST COMMUNITY HOMES INC
Entity type:Organization
Organization Name:NORTH COAST COMMUNITY HOMES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:STROUP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-662-1893
Mailing Address - Street 1:14221 BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44125-1953
Mailing Address - Country:US
Mailing Address - Phone:216-662-1880
Mailing Address - Fax:
Practice Address - Street 1:14221 BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44125-1953
Practice Address - Country:US
Practice Address - Phone:216-662-1880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH14444Medicaid