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Charisse Lillian Ali
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Ashtabula, Ohio
NPI 1396331005

Charisse Lillian Ali is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Ashtabula, OH. Charisse Lillian Ali practices in Ashtabula, OH. The NPI Number for Charisse Lillian Ali is 1396331005 and holds a License No. (Ohio).

The current practice location address for Charisse Lillian Ali is 1440 W Prospect Rd, Ashtabula, OH and can be reached out via phone at 440-319-2078 and via fax at 440-998-5820.

Location: 1440 W Prospect Rd, Ashtabula, OH, 44005-0548
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1396331005
Provider Name
Charisse Lillian Ali
Credential
Provider Entity Type
Individual
Gender
Female
Address
1440 W Prospect Rd, Ashtabula, OH, 44005-0548
Phone Number
440-319-2078
Fax Number
440-998-5820
Provider Enumeration Date
12/16/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1440 W Prospect Rd
City
Ashtabula
State
Ohio
Zip
44004-6668
Phone Number
440-319-2078
Fax Number
440-998-5820
person
Provider Business Mailing Address Details
Address
1440 W Prospect Rd
City
Ashtabula
State
Ohio
Zip
44004-6668
Phone Number
440-319-2078
Fax Number
440-998-5820
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.
()
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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