Provider Demographics
NPI:1750085890
Name:WILKES CARE LIVING CO.
Entity type:Organization
Organization Name:WILKES CARE LIVING CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILKES
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:216-575-8796
Mailing Address - Street 1:20931 RECHER AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44119-2441
Mailing Address - Country:US
Mailing Address - Phone:216-575-8796
Mailing Address - Fax:
Practice Address - Street 1:20931 RECHER AVE
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44119-2441
Practice Address - Country:US
Practice Address - Phone:216-575-8796
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty