Provider Demographics
NPI:1104602978
Name:MMS ADULT DAY CENTER
Entity type:Organization
Organization Name:MMS ADULT DAY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:PORSCHE
Authorized Official - Middle Name:L
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-232-6695
Mailing Address - Street 1:4536 WARNER RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-6551
Mailing Address - Country:US
Mailing Address - Phone:216-232-6695
Mailing Address - Fax:
Practice Address - Street 1:4536 WARNER RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-6551
Practice Address - Country:US
Practice Address - Phone:216-232-6695
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day CareGroup - Multi-Specialty
No373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services