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Independent Provider
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Euclid, Ohio
NPI 1033650163

Independent Provider is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Euclid, OH. Independent Provider practices in Euclid, OH. The NPI Number for Independent Provider is 1033650163 and holds a License No. SP841892 (Ohio).

The current practice location address for Independent Provider is 288 E 248Th St, Euclid, OH and can be reached out via phone at 216-303-4144.

Location: 288 E 248Th St, Euclid, OH, 44123-1437
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1033650163
Provider Name
Independent Provider
Credential
Provider Entity Type
Organization
Address
288 E 248Th St, Euclid, OH, 44123-1437
Phone Number
216-303-4144
Fax Number
Provider Enumeration Date
03/08/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
288 E 248Th St
City
Euclid
State
Ohio
Zip
44123-1437
Phone Number
216-303-4144
Fax Number
person
Provider Business Mailing Address Details
Address
288 E 248Th St
City
Euclid
State
Ohio
Zip
44123-1437
Phone Number
216-303-4144
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
SP841892 (Ohio)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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