Provider Demographics
NPI:1811704778
Name:DEVINS PLACE
Entity type:Organization
Organization Name:DEVINS PLACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:LATISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:CROWE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, EFM, ACLS
Authorized Official - Phone:216-868-6641
Mailing Address - Street 1:4396 AMMON RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44143-2804
Mailing Address - Country:US
Mailing Address - Phone:216-868-6641
Mailing Address - Fax:
Practice Address - Street 1:4396 AMMON RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44143-2804
Practice Address - Country:US
Practice Address - Phone:216-868-6641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-13
Last Update Date:2024-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
No253Z00000XAgenciesIn Home Supportive Care
No310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness